{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:50:56Z","timestamp":1789487456161,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000589","name":"Chief Scientist\u2019s Office","doi-asserted-by":"crossref","award":["HIPS\/19\/52"],"award-info":[{"award-number":["HIPS\/19\/52"]}],"id":[{"id":"10.13039\/501100000589","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100012095","name":"Scottish Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the feasibility and acceptability of delivering risk-stratified low-dose CT (LDCT) lung cancer screening across diverse geographical and socioeconomic settings in Scotland and to characterise uptake, participant profile and screening outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, multicentre pilot feasibility study with descriptive analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary and secondary care interface across four regional Health Boards in Scotland, encompassing urban, rural, remote and socioeconomically deprived populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>2801 individuals aged 50\u201374 years, identified from primary care electronic medical records (EMRs), with a history of smoking were invited (current or within 15 years where available); 668 (23.8%) responded. Of 608 assessed for eligibility (50.8% female; median age 63 years), 503 (82.7%) met at least one predefined high-risk criterion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Invitation to a lung health check, followed by telephone-based risk assessment using US Preventative Services Task Force, Liverpool Lung Pathway version 2 and the Prostate, Lung, Colorectal and Ovarian Screening Trial criteria. High-risk participants were offered a one-off LDCT scan at local centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary: feasibility indicators including uptake, risk eligibility and scan completion. Secondary: prevalence of lung cancer, pulmonary nodules and incidental findings (eg, coronary artery disease, emphysema).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Response rate was 23.8% (668\/2801), varying from 17.8% to 38.1% across practices and lower in more deprived areas. Of 503 eligible participants, 436 (86.7%) underwent LDCT. Abnormal findings were present in 83.3% of scans. Lung nodules were detected in 25.7% (112\/436), with 11.8% requiring follow-up. Lung cancer was diagnosed in 1.15% (5\/436; 95%), alongside five additional malignancies. Coronary artery disease was identified in 56.4% (246\/436) and emphysema in 33% (144\/436). Non-responders were more likely to be current smokers (69.3% vs 49.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recruitment of people for lung cancer screening using the smoking history recorded in their primary care EMR is feasible. This approach identifies a high-risk population with a high burden of both malignant and non-malignant disease, and with substantial undiagnosed disease burden. However, uptake was modest and socially patterned, highlighting the need for equity-focused implementation strategies, including repeated invitations and targeted engagement. These findings are particularly relevant as Scotland considers implementation of a national lung cancer screening programme within a health system characterised by marked geographical and socioeconomic inequalities. Further research should evaluate long-term outcomes, cost-effectiveness and strategies to improve equitable participation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-120569","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:01:32Z","timestamp":1789480892000},"page":"e120569","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pilot feasibility study to deliver low-dose CT lung cancer screening in Scotland: descriptive findings from the LungScot study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5419-6331","authenticated-orcid":false,"given":"Debbie","family":"Cavers","sequence":"first","affiliation":[{"name":"Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsan R","family":"Akram","sequence":"additional","affiliation":[{"name":"Centre for Inflammation Research, The University of Edinburgh The Queen\u2019s Medical Research Institute, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-421X","authenticated-orcid":false,"given":"Elizabeth K","family":"Sage","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, NHS Highland, Inverness, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Maclay","sequence":"additional","affiliation":[{"name":"Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon W","family":"Cowell","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Dickie","sequence":"additional","affiliation":[{"name":"Beatson West of Scotland Cancer Centre, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4868-0554","authenticated-orcid":false,"given":"Christine","family":"Campbell","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-0411","authenticated-orcid":false,"given":"Kathryn A","family":"Robb","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6623-4964","authenticated-orcid":false,"given":"Frank","family":"Sullivan","sequence":"additional","affiliation":[{"name":"University of St. Andrews, St Andrews, UK"},{"name":"Department of Family and Community Medicine & Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"University of Dundee, Dundee, UK"},{"name":"University of Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9968-5991","authenticated-orcid":false,"given":"Peter","family":"Murchie","sequence":"additional","affiliation":[{"name":"Division of Applied Health Science, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3758-0566","authenticated-orcid":false,"given":"Aileen","family":"Neilson","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit (ECTU), Usher Institute, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J 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