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Every targeted result on this roadmap depends on a test happening fast enough to act on. In England nobody publishes what share of lung cancers are tested, how long the test takes, or, in Wales and Northern Ireland, how long the lung pathway takes at all.
The United Kingdom and NHS page for lung cancer set out to record what the NHS delivers against what the evidence says, and four of its findings are absences rather than figures.
The first is the reflex testing rate. A full-text search of the National Lung Cancer Audit's State of the Nation 2026 report for EGFR, ALK, ROS1, PD-L1, molecular, genomic and biomarker returns a single hit, in a recommendation asking trusts to ensure molecular pathology capacity. No published figure says what proportion of English lung cancer patients receive the testing NICE NG122 requires before treatment.
The second is turnaround. The National Genomic Test Directory has no turnaround column, and NHS England's genomic testing activity release says waiting-time data is planned for a future publication. The newest figures anyone can quote are from the 2019 GIRFT and audit organisational survey and an audit spotlight on people diagnosed in 2017.
The third is who gets an operation. No NHS England document names the thoracic surgery centres: service specification 170016/S sets the volume rules and says there were 29 units in England when it was written, lists none of them, and has not been refreshed since July 2017. The centre list on the UK page is assembled from the audit's resection counts instead.
The fourth is time. Wales reports its suspected cancer pathway for all cancers together, with no lung-specific figure; Northern Ireland publishes no 28-day faster diagnosis standard and splits lung out only for the 31-day one.
The proposal is that the four be published, on the same cycle as the audit, so that the pathway can be measured where it actually breaks.
The document that defines who is offered a scan in the United States, and therefore the document any argument about the screening eligibility gap has to engage with. Eligibility is still defined by pack-years and years since quitting rather than by an individual risk estimate.
The deprivation gradient in lung cancer is not only about who gets the disease. Among people who already have it, and at the same stage, poorer patients are less likely to be offered the treatment that works.
The case for re-biopsy at progression, for treating resistance as a diagnosis rather than an endpoint, and for the idea of a drug holiday. It is also the origin of resistance-directed sequencing: what you give next should depend on what the tumour became.
Shares Take lung screening scanners to supermarket car parks in the poorest areas, Socioeconomic inequalities in lung cancer treatment: systematic review and meta-analysis, Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch and the tag lung-evidence.
Shares Take lung screening scanners to supermarket car parks in the poorest areas, Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Fragmented care and guideline gaps and the tag lung-evidence.
Shares Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors, Diagnostics roadmap: stains → gene panels → blood tests that decide treatment, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Next-generation sequencing (NGS) and the tag lung-evidence.
Shares Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late, Most of the world has almost no cancer care and the tag lung-evidence.
Shares Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late, Liquid biopsy (ctDNA) and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Next-generation sequencing (NGS), The hardest cancers are found late, Liquid biopsy (ctDNA) and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, The hardest cancers are found late, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Next-generation sequencing (NGS), Lung cancer (all types) and the tag lung-evidence.