This Comment represents independent research supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at The Royal Marsden National Health Service (NHS) Foundation Trust and the Institute of Cancer Research, London, UK. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care England, or NHS England. Where authors are identified as personnel of the International Agency for Research on Cancer or WHO, the authors alone are responsible for the views expressed in this Comment and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer or WHO. RL reports funding indirectly related to this work from the Royal Marsden Cancer charity, Cancer Research UK, Innovate UK (co-funded by Roche), RM Partners Cancer Alliance, the NIHR, and NHS England, and unrelated to this topic consulting fees from Royal Marsden Private Care for personal private practice and is NHS England Joint National Clinical Lead for the Targeted Lung Health Check Programme and NIHR Clinical Research Network National Specialty Lead for Screening, Prevention and Early Detection. HAR reports funding unrelated to this work from the US National Cancer Institute, the Institut National du Cancer (France), World Cancer Research Fund International, and the Lung Cancer Research Foundation.