Check if you need a lung scan prototype

A digital questionnaire prototype for lung cancer screening eligibility and risk assessment, built with the NHS prototype kit.

The prototype explores whether people can complete parts of the lung cancer screening questionnaire online instead of completing the whole assessment by phone.

Current prototype

The latest version is prototype v4.4.

• Start page: /prototype_v4_4/start-page
• Page index: /prototype_v4_4/page-index
• Last updated in the prototype index: 9 July 2026

The app also keeps earlier versions available for comparison and research review:

• prototype_v4_3
• prototype_v4_2
• prototype_v4_1
• prototype_v4
• prototype_v3
• prototype_v2
• prototype_v1

What v4.4 includes

Prototype v4.4 includes:

• simulated NHS login and security code pages
• terms acceptance
• an exit route for people who have already completed the questionnaire by phone
• eligibility checks for smoking history and age
• a route for people who need a face-to-face appointment
• height, weight, gender identity, sex at birth, ethnicity and education questions
• smoking history and tobacco type questions
• repeated tobacco questions for cigarettes, rolling tobacco, pipes, cigars, cigarillos and shisha
• respiratory conditions, asbestos, cancer diagnosis and family history questions
• check your answers and confirmation pages
• content pages for accessibility, contact, cookies, privacy, terms, paused and closed service states
• 404, 500 and 503 error pages

The v4.4 flow is documented in app/prototype_v4_4/docs/question-flow.md.

Content and data

Prototype v4.4 uses YAML-backed content for most standard question pages:

• app/prototype_v4_4/data/questions.yaml for reusable question controls
• app/prototype_v4_4/data/pages.yaml for page composition
• app/prototype_v4_4/data/tobacco.yaml for tobacco-specific content and repeated tobacco sub-flows

The YAML content hot-reloads while the app is running. If invalid YAML is saved, the next request can fail until the file is fixed.

Version-specific documentation is in app/prototype_v4_4/docs.

Shared project documentation is in docs, including:

• a contribution guide
• risk calculator notes
• tobacco cigarette-equivalent notes and CSV data
• a modelling note about concurrent and consecutive tobacco smoking

Risk calculators

The repository includes shared prototype-only LLPv2 and PLCOm2012 calculator modules in app/lib/risk-calculators.

These modules are not currently wired into the v4.4 journey to decide whether a person is high risk or low risk. The next implementation step is an adapter that maps prototype session answers to calculator inputs and owns thresholds, missing answer handling, cigarette-equivalent mapping and result page routing.

Calculator results are not clinically signed off and must not be used to make clinical decisions.

See docs/risk-calculators.md.

Running locally

Use the project Node and npm versions:

• Node 24
• npm 11

Install dependencies and start the prototype:

npm install
npm start

The prototype runs at http://localhost:3000.

Local environment variables can be set in a .env file. Copy .env.example to .env and change the values you need:

PHASE_BANNER_TAG_TEXT="Pilot"
PHASE_BANNER_TAG_CLASSES="nhsuk-tag--blue"

Useful commands

npm run lint:markdown
npm run lint:scripts
npm run lint:styles

Research status

This is a research prototype for user testing and service design work. It is not intended for clinical use.

Contributing

For non-technical contribution guidance, see docs/contributing-to-the-prototype.md.

Licence

This prototype is built using the NHS prototype kit and follows the same licensing terms.