New study aims to improve early detection of lung cancer
A major new study, MEDLEY, is underway with recruitment in several UK cities. The project, funded by the National Institute for Health Research (NIHR), seeks to determine whether low-dose computed tomography (CT) scans can improve the early detection of lung cancers compared with the traditional chest X-ray, which is currently the usual first-line test for people with potential respiratory symptoms.
What is MEDLEY trying to compare?
Right now, most general practice (GP) pathways rely on chest X-rays to rule in or out cancer when patients present with persistent coughs or other worrying respiratory symptoms. But X-rays miss a significant portion of lung cancers—estimates suggest up to 20%. Early detection is crucial because lung cancer remains the leading cause of cancer deaths in the UK, and identifying cancers before symptoms progress could save many lives.
MEDLEY brings a potential alternative to the table: low-dose CT scans. These scans are more sensitive than X-rays at spotting lung abnormalities. The key question MEDLEY will address is whether offering low-dose CT scans to patients who visit their GP with concerning symptoms leads to earlier cancer diagnosis and better outcomes, compared with continuing to use chest X-rays alone.
How the study works
Researchers from the Universities of Leeds, Sheffield, Exeter and Nottingham, along with Queen Mary University of London and University College London, have begun recruiting about 900 volunteers. When a patient attends a GP with worrying respiratory symptoms and an X-ray is requested, they may be invited to participate. All participants will still receive the standard chest X-ray, but those who enroll in MEDLEY will also undergo a low-dose CT scan. The scan results, which may also identify other respiratory conditions, will be shared with the patient’s GP to inform management decisions.
Participants will receive information about the process and will have access to specialists by phone or email. Importantly, the study notes that low-dose CT scans deliver radiation exposure comparable to a person’s average weekly environmental radiation, providing reassurance about safety in the context of potential benefits.
Why take part and what could be learned
MEDLEY will help determine whether a diagnostic pathway that uses low-dose CT scans more broadly could identify cancers earlier, potentially enabling timely treatment and improved survival. However, CT scans are more expensive and take longer than X-rays, so the study will also explore how to optimize use of resources. One likely outcome is that, if a national rollout proves cost-effective, only high-risk groups (based on age, smoking history, and other factors) might be prioritized for CT scanning rather than applying it to every patient with a chest X-ray.
Myriad factors influence how healthcare systems allocate resources, and the NHS is currently stretched. MEDLEY’s researchers will model whether risk-based criteria could help clinicians decide who should receive a CT scan in place of, or in addition to, a chest X-ray, without delaying care for others.
Expert perspectives and the study’s significance
Professor Mat Callister and Professor Anthony Gordon, among MEDLEY’s senior team, emphasize the vital goal of early diagnosis when treatments work best. “We need to diagnose lung cancer early, when treatments are most effective, and we know chest X-ray isn’t always sufficient,” says Callister. Gordon highlights the importance of NIHR funding in tackling major killers by supporting studies that refine how we identify and treat illnesses more effectively.
MEDLEY has secured £1.2 million in NIHR funding and is expected to run for about three years. If the study demonstrates clear benefits of low-dose CT over chest X-ray for certain patients, it could influence future NHS guidelines and a potential shift toward more precise, risk-guided imaging pathways for lung cancer.
What this means for patients and the future
For patients, the research represents an important step in exploring whether a simple scan—perceived as more accurate—could lead to earlier intervention and better outcomes. For clinicians and policymakers, the results could inform decisions about resource allocation, test ordering, and the design of nationwide screening or diagnostic strategies that prioritize those most likely to benefit.
As lung cancer remains the UK’s deadliest cancer, advances in early detection are a critical aim. MEDLEY’s findings will be watched closely by the NHS, researchers, and patient groups alike, as they seek to balance clinical benefit with sustainable health service delivery.
