The Manchester Lung Health Study (qUEST) will assess the uptake of a community-based lung cancer screening service and its impact across a deprived area of North and East Manchester, which has high rates of lung cancer. One measure will be to compare the number and stage of lung cancers detected through screening to those detected outside of screening. In addition we will investigate the potential of a blood and nose test to detect lung cancer or to help decide who would benefit from screening. We will also see if these samples can help with the interpretation of CT scans. One of the problems with lung cancer CT screening is that you detect lung nodules in which we are not sure if they are benign or cancerous. Therefore we are also looking to see if a biomarker can help us work out which are cancerous and which are benign.
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Main data study: Inclusion Criteria: \- Any individual attending the Manchester Lung Health service who has a lung health check as they meet the service inclusion exclusion criteria (see below): Manchester Lung Health service inclusion criteria: * Age 55-80 * Ever smoker * Registered with a GP in the North or East Manchester area Manchester Lung Health service exclusion Criteria: * Lung cancer diagnosis within 5 years * Listed on a palliative care register * Chest CT scan within 3 months Exclusion Criteria: \- Unable to give informed consent to study participation. Biomarker sub-study: Inclusion Criteria: * Any individual attending the M-LHC service who is eligible and agrees to undergo LDCT screening. * Has consented to the main study. Exclusion Criteria: * Unable to give informed consent to study participation * Decline participation in LDCT lung cancer screening * Known blood borne virus e.g. HIV or Hepatitis B, C