Introduction
 
Doncaster, UK, (pop. >300,000 with high smoking prevalence) implemented the national targeted lung health check (TLHC) pilot programme from Apr-21. Ever smokers (55-75y) registered with Doncaster GP practices were invited. Those with high cancer risk scores were offered a low-dose CT with a roving mobile van.
 
While TLHC was active (Apr-21 to Dec-22), 557 lung cancers were diagnosed in Doncaster: 148 through TLHC (76% in early stages [I/II]) and 409 outside the programme (55% in late stages [III/IV]).

Aims
 
For improvement of the programme, we looked at the demographic data of lung cancer patients diagnosed outside TLHC.
 
Methods
 
The Doncaster lung cancer database was searched for cases from Apr-21 to Dec-22 and mapped to TLHC data. The cohort of diagnoses made outside of the programme were identified.

Results
 
Out of 557 newly diagnosed lung cancers, 334 (60%) were within the age range of the programme. Of these, 186 age-eligible patients were diagnosed outside the programme: 50 uncontactable, 25 declined, 4 deceased, 12 did not meet the criteria on initial calls and 3 had low cancer risk score.
 
92 patients were not registered with the programme. 71 were found to be ever smokers and should have qualified for the programme by age and smoking criteria. Majority (54 out of 71) were of stage III/IV. 6 never smokers and 2 passive smokers were not qualified. Smoking status was unknown in 11 patients.

Conclusion
 
Enhancing the robustness of data in GP registers would improve effectiveness of TLHC. Passive smokers were left out of the programme as not covered by the current criteria. Continued health education in parallel to the programme may improve engagement.