The NHS has launched a pilot combining artificial intelligence and robotic bronchoscopy to find small, hard-to-reach lung cancers earlier and reduce the need for multiple invasive tests. The approach uses AI to quickly review CT scans and flag nodules most likely to be malignant. A robotic camera then steers ultra-thin biopsy tools deep into the airways with greater precision than standard methods, reaching nodules as small as 6 mm — about the size of a grain of rice — that are often difficult or risky to sample.
When AI highlights higher-risk areas on a scan, clinicians can take a targeted tissue sample in a single procedure that typically takes around half an hour. This can replace weeks of repeat imaging and appointments for many patients, shortening the diagnostic pathway, reducing uncertainty and avoiding more invasive surgery where it is not needed.
The pilot at Guy’s and St Thomas’ is being introduced alongside plans to expand the NHS lung cancer screening programme, which aims to invite every eligible person for checks within five years as part of the National Cancer Plan. The screening expansion intends to invite about 1.4 million people next year and is expected to diagnose up to 50,000 cancers by 2035, with at least 23,000 detected at an earlier, more treatable stage. Targeted lung health checks that began in 2021 have already attracted more than 1.5 million attendees and have helped identify thousands of earlier-stage cancers, with early diagnosis rates rising fastest in the most disadvantaged areas.
NHS clinical leaders say the pilot offers a practical example of how technology can improve cancer detection. Professor Peter Johnson, NHS England’s National Clinical Director for Cancer, called the project a glimpse of the future for cancer detection, noting that the combination of AI and robotics gives clinicians a clearer view inside the lungs and supports faster, more accurate biopsies. Health and Social Care Secretary Wes Streeting, who has experience of robotic surgery, said the work is life-changing for patients waiting for answers and supports the move from late diagnosis to early intervention.
Dr Anne Rigg, Medical Director for Cancer and Surgery at Guy’s and St Thomas’, said integrating AI risk stratification with precise robotic biopsy shortens and simplifies the diagnostic pathway, cutting delays and unnecessary steps. The pilot was co-designed with patients and frontline teams to make the pathway faster, safer, more equitable and more focused on patient experience, she added.
One early patient to benefit was David Lindsay of Streatham, London. After being referred for a suspected deep vein thrombosis in September 2025, imaging incidentally revealed a lung nodule. A robotic bronchoscopy at Guy’s Hospital confirmed stage 1 lung cancer (primary adenocarcinoma of the left lower lobe). David later had a lung-sparing robotic operation and described the bronchoscopy as quick and painless, saying the DVT referral had been a blessing in disguise that led to early detection.
During testing, Guy’s and St Thomas’ performed around 300 robotic biopsy procedures; 215 patients subsequently received cancer treatment, while others were spared more complex surgery after benign results. From January the pilot will formally launch at Guy’s and St Thomas’, with planned expansion to King’s College Hospital NHS Foundation Trust and Lewisham and Greenwich NHS Trust so more patients can benefit.
Technology Secretary Liz Kendall said robotics and AI will speed access to treatment and improve outcomes, calling the programme an example of the UK harnessing technology to change lives. Dr Jesme Fox, Medical Director at the Roy Castle Lung Cancer Foundation, welcomed the pilot and reiterated the importance of taking part in the Lung Cancer Screening Programme when invited, noting that screening has already saved thousands of lives by detecting curable early-stage disease.
If the pilot proves successful, its results will inform a national commissioning policy for robotic bronchoscopy and help make access more consistent across the NHS. Full evaluation will assess patient and service outcomes; conclusions about survival, waiting times and cost-effectiveness will follow when the pilot is complete.
Additional details: the pilot is funded through the NHS Cancer Programme – Innovation Open Call (SBRI Healthcare). It is the first NHS pilot to integrate Optellum’s AI risk stratification with Intuitive’s Ion robotic bronchoscopy in an end-to-end diagnostic pathway. Optellum’s Virtual Nodule Clinic is already used by multiple NHS organisations to support nodule assessment, and the Ion system uses a shape-sensing ultra-thin tube to navigate deep into the lung for precise biopsies.
