Patients with suspected lung cancer could get answers sooner under a new NHS pilot combining artificial intelligence and robotic bronchoscopy to find hard-to-detect cancers earlier and reduce invasive tests.
The approach uses AI to rapidly analyse lung CT scans and flag small nodules most likely to be cancerous. A robotic camera then guides biopsy tools through the airways with greater precision than standard techniques, reaching nodules as small as 6mm — about the size of a grain of rice — hidden deep in the lung that are often too risky or difficult to access otherwise.
Once AI highlights higher-risk areas, clinicians can take a precise tissue sample for specialist laboratory review to confirm or rule out cancer. For many patients, weeks of repeat scans and procedures could be replaced by a single, half-hour biopsy, reducing prolonged uncertainty and avoiding more invasive surgery.
The pilot 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 to tackle inequalities in cancer outcomes as part of the National Cancer Plan. Lung cancer contributes to a year of the nine-year life expectancy gap between richer and poorer parts of England. Since 2021, more than 1.5 million people have attended an NHS lung health check, helping identify thousands of cancers at an earlier, more treatable stage.
The expansion will invite around 1.4 million people for a lung cancer check next year. The programme is expected to diagnose up to 50,000 cancers by 2035, with at least 23,000 detected at an earlier stage, potentially saving thousands of lives.
Professor Peter Johnson, NHS England’s National Clinical Director for Cancer, described the Guy’s and St Thomas’ pilot as “a glimpse of the future of cancer detection,” saying AI and robotics give clinicians a clearer look inside the lungs and support faster, more accurate biopsies. Health and Social Care Secretary Wes Streeting noted his own experience with robotic surgery and called the pilot “life-changing” for patients waiting for answers, saying it supports the shift from late diagnosis to early intervention under the National Cancer Plan.
Dr Anne Rigg, Medical Director for Cancer and Surgery at Guy’s and St Thomas’, said combining AI-enabled risk stratification with precise robotic biopsy simplifies and shortens the diagnostic pathway, reducing delays and unnecessary steps. She emphasised the pilot is co-designed with patients and frontline teams to ensure the pathway is faster, safer, more equitable and centred on patient experience, helping reduce variation in care.
One early beneficiary is David Lindsay, an IT contractor from Streatham, London. After referral for a suspected deep vein thrombosis in September 2025, imaging revealed an incidental lung nodule. A robotic bronchoscopy at Guy’s Hospital confirmed stage 1 lung cancer (primary adenocarcinoma of the left lower lobe). David had a lung-sparing robotic operation to remove the cancer and described the bronchoscopy as “quick and painless,” praising staff and saying the DVT was a “blessing in disguise” that led to early detection.
Guy’s and St Thomas’ has already performed around 300 robotic biopsy procedures during testing, with 215 patients going on to receive cancer treatment and others spared more complex procedures after benign results. From January the pilot formally launches at Guy’s and St Thomas’, with planned expansion to King’s College Hospital NHS Foundation Trust and Lewisham and Greenwich NHS Trust to allow more patients to benefit.
Technology Secretary Liz Kendall said robotics and AI will speed access to treatment and deliver improved outcomes, calling this work 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 finding curable early-stage disease.
If successful, the pilot will generate evidence to develop a national commissioning policy for robotic bronchoscopy and support more consistent access across the NHS.
Further information
– The pilot is funded through the NHS Cancer Programme – Innovation Open Call (SBRI Healthcare).
– This is the first NHS pilot to integrate Optellum’s AI risk stratification with Intuitive’s Ion robotic bronchoscopy in an end-to-end lung cancer diagnostic pathway.
– Optellum’s Virtual Nodule Clinic is already used across multiple NHS organisations to support nodule assessment.
– The Ion robotic bronchoscopy system uses an ultra-thin, shape-sensing tube to navigate deep into the lung and take precise biopsy samples.
– Full evaluation will assess patient and service outcomes; claims about survival, waiting times or cost-effectiveness will follow once the pilot is complete.
– NHS data shows that since targeted lung health checks began in 2021, early diagnosis rates for lung cancer have grown more rapidly in the most disadvantaged areas.
