A health impact assessment (HIA) of a national lung cancer screening programme in Wales
Abstract
Lung cancer is a major cause of death in Wales, with late diagnosis contributing to poor outcomes. This is exacerbated by inequalities such as accessibility, socioeconomic status and rurality. As Wales developed a national Lung Cancer Screening Programme (LCSP) in 2024, a prospective Health Impact Assessment (HIA) was undertaken to understand potential health, wellbeing and equity impacts to support evidence-based decision making. Public Health Wales conducted the HIA using mixed methods, including national data analysis, Welsh Pilot evidence, published research and a participatory stakeholder workshop. The HIA explored potential positive/negative impacts, affected groups and led to recommendations for action for equitable delivery. The HIA was undertaken over several months to contribute to a Welsh Government decision in 2025. The HIA identified major potential benefits, including earlier detection of lung cancer and other respiratory conditions, improved smoking cessation opportunities and increased access to wider support services. Potential negative impacts included communication challenges, transport and cost barriers, stigma, digital exclusion and accessibility issues. Affected groups included rural communities, socioeconomically disadvantaged people, transient populations and people with disabilities. Recommendations such as multilingual communication, trauma‑informed practice, community engagement and strong links with cessation services were made, to inform evidence which contributed to programme funding approval. The HIA demonstrated the value of early engagement using HIA to support equitable implementation of the LCSP.Key lessons included the importance of accessible communication, flexible delivery models and working with other services. As the first known HIA for a lung cancer screening programme globally, it offers transferable learning for other countries seeking to implement a similar programme maximising benefits and reducing inequalities.
Key messages: • HIA is a beneficial process to support equitable decision making and prevention approaches.
• Lung Cancer Screening programmes have major potential positive impacts for health and wellbeing.
Related
- Mixed-methods evaluation of a rights-based intervention to reduce long-term segregation in mental health services: the HOPE(S) National Programme in England.
- Embedding health equity in Austria’s new public health-oriented national cancer control programme
- Social determinants of health and multidimensional health screening findings among immigrants participating in a community-based programme in Portugal: a cross-sectional study
- Impact of a primary care prevention programme on health behaviour change: a pre-post study in Poland
- Stakeholder perspectives on the development of a school based mental health programme in Bangladesh: a qualitative needs assessment.
BibTeX
@article{green2026health,
title = {{A health impact assessment (HIA) of a national lung cancer screening programme in Wales}},
author = {L Green and K Ashton and C Lyddon and S Shabang and J Sharp and C Coslett and H Rameseur-Marsden and M Khaw},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1042},
url = {https://doi.org/10.1093/eurpub/ckag169.1042},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A health impact assessment (HIA) of a national lung cancer screening programme in Wales
AU - L Green
AU - K Ashton
AU - C Lyddon
AU - S Shabang
AU - J Sharp
AU - C Coslett
AU - H Rameseur-Marsden
AU - M Khaw
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1042
UR - https://doi.org/10.1093/eurpub/ckag169.1042
AB - Lung cancer is a major cause of death in Wales, with late diagnosis contributing to poor outcomes. This is exacerbated by inequalities such as accessibility, socioeconomic status and rurality. As Wales developed a national Lung Cancer Screening Programme (LCSP) in 2024, a prospective Health Impact Assessment (HIA) was undertaken to understand potential health, wellbeing and equity impacts to support evidence-based decision making. Public Health Wales conducted the HIA using mixed methods, including national data analysis, Welsh Pilot evidence, published research and a participatory stakeholder workshop. The HIA explored potential positive/negative impacts, affected groups and led to recommendations for action for equitable delivery. The HIA was undertaken over several months to contribute to a Welsh Government decision in 2025. The HIA identified major potential benefits, including earlier detection of lung cancer and other respiratory conditions, improved smoking cessation opportunities and increased access to wider support services. Potential negative impacts included communication challenges, transport and cost barriers, stigma, digital exclusion and accessibility issues. Affected groups included rural communities, socioeconomically disadvantaged people, transient populations and people with disabilities. Recommendations such as multilingual communication, trauma‑informed practice, community engagement and strong links with cessation services were made, to inform evidence which contributed to programme funding approval. The HIA demonstrated the value of early engagement using HIA to support equitable implementation of the LCSP.Key lessons included the importance of accessible communication, flexible delivery models and working with other services. As the first known HIA for a lung cancer screening programme globally, it offers transferable learning for other countries seeking to implement a similar programme maximising benefits and reducing inequalities. Key messages: • HIA is a beneficial process to support equitable decision making and prevention approaches. • Lung Cancer Screening programmes have major potential positive impacts for health and wellbeing.
SN - 1101-1262
SN - 1464-360X
ER -