Lung cancer is associated with a poor prognosis and is the most common cause of cancer death worldwide [1,2]. Recognising and treating lung cancer at an earlier stage is associated with improved survival [3]. In the UK, lung cancer is frequently picked up on chest x-rays (CXR) either as part of an ‘urgent suspicion of cancer’ pathway or as an incidental finding. Whilst the former has national time targets for x-ray turnaround time, the latter is more susceptible to delays due to the high volume …