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Article History

Received: 29 December 2025

Revised: 3 March 2026

Accepted: 28 March 2026

First Online: 6 May 2026

Compliance with ethical standards

Guarantor: The scientific guarantor of this publication is Dr Richard W. Lee.

Conflict of interest: The authors of this manuscript declare relationships with the following companies: Dr Kalsi is funded by the Royal Marsden and ICR National Institute of Health and Care Research (NIHR) Biomedical Research Centre, and Royal Marsden Cancer Charity. Dr Lee is funded by the Royal Marsden and ICR National Institute of Health and Care Research (NIHR) Biomedical Research Centre, and Royal Marsden Cancer Charity. Dr Lee’s institution receives compensation for time spent in a secondment role for the NHS England lung health check programme and as National Specialty Lead for the NIHR. He has received research funding from CRUK, Innovate UK (co-funded by GE Healthcare, Roche Diagnostics, Optellum, Elliptica, and RNA Guardian); SBRI (including as a co-applicant with QURE.AI), RM Partners Cancer Alliance; and NIHR (including co-applicant in grants with Optellum). He has received honoraria, speaker/advisory fees, and/or hospitality/travel expenses from CRUK, Roche Diagnostics, Johnson & Johnson, Guardant, AstraZeneca, and King Faisal Hospital, Saudi Arabia. He also undertakes medical private practice. Professor Aboagye is funded by the Imperial College London Biomedical Research Centre (ICL-BRC), Experimental Cancer Medicines Centre (ECMC) and National Cancer Imaging Translational Accelerator Consortium (NCITA). Professor Aboagye also acknowledges the Medical Research Council (MRC). Professor Devaraj is employed by and has stocks in Brainomix. He receives consulting fees from Roche and Boehringer Ingelheim. Dr Nair receives research grants from the Department of Health’s NIHR Biomedical Research Centre and GRAIL. He has received consulting fees from Aidence BV, Faculty Science Limited and MSD. He has received a travel bursary from Takeda. He participates on advisory boards for Aidence BV and Faculty Science Limited. He has leadership roles within the British Society of Thoracic Imaging, the British Lung Foundation and the NHS England Targeted Lung Health Checks Programme.

Statistics and biometry: Dr Nuria Porta kindly provided statistical advice for this manuscript.

Informed consent: Written informed consent was waived by the Institutional Review Board.

Ethical approval: Institutional Review Board approval was obtained.

Study subjects or cohorts overlap: Not applicable.

Methodology: