Hilary Robbins, BSc, MSPH, PhD, International Agency for Research on Cancer, Lyon, France, discusses an investigation into the disparate lung cancer detection rate in the Manchester Lung Health Checks compared to the US National Lung Screening trial (NLST). The Manchester screens had a markedly higher detection rate than the NLST. Numerous influential factors were identified, including the use of risk-based eligibility in Manchester, and a higher average population risk. Even when these influences were accounted for, detection was still significantly higher in Manchester than NLST, notably in lesser educated and lower smoking intensity groups. This interview took place during the IASLC World Conference on Lung Cancer (WCLC) virtual meeting 2021.