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UK experts decry lung cancer diagnoses via A&E

31 Jan 2020
UK experts decry lung cancer diagnoses via A&E

Emergency hospital admission is still the most common route for diagnosing lung cancer.

This is ‘a travesty’, insists a new report published by the UK Lung Cancer Coalition. 

According to the UK Lung Cancer Coalition (UKLCC), patients diagnosed via emergency are over five times more likely to die within one year of diagnosis than those referred for treatment by their GP.

“The UK has some of the worst lung cancer survival rates in Europe. This is because lung cancer is being diagnosed too late, often after an emergency presentation,’ declared Professor Mick Peake, Clinical Director, Centre for Cancer Outcomes, and Chair of the UKLCC’s Clinical Advisory Group which authored the report.

In England, around 40 per cent of people with lung cancer first reach specialist care via an emergency admission to hospital.

In addition, across the country there is a five-fold variation in the proportion of lung cancers first diagnosed via an emergency.

“Diagnosing lung cancer at an early stage can lead to more treatment options and better outcomes for patients,” added Professor Peake.

According to the Office of National Statistics, nearly nine out of ten (88%) lung cancer patients will survive for at least a year if diagnosed early (stage 1), compared to only one fifth (19%) who are diagnosed with the most advanced stage of disease.

The UKLCC’s report, ‘Early Diagnosis Matters: Making the Case for the Early and Rapid Diagnosis of Lung Cancer’, lays out 10 key recommendations for diagnosing lung cancer earlier in order to increase lung cancer survival. These include:

  • The National Lung Cancer Audit (NLCA), which collects data on lung cancer treatments and outcomes, must continue uninterrupted and better define the nature and potential causes of variation at regional and local level. 
  • Public awareness and action campaigns focused on lung cancer should be funded every year - alongside regional and local campaigns to support improved understanding of signs and symptoms
  • Stop smoking services should be encouraged to use their contact with smokers to increase awareness of the symptoms of lung cancer and the value of early detection  
  • High quality GP education programmes - with impactful content focused on the early recognition, investigation and referral of lung cancer - should be rolled out
  • The new 28-day cancer Faster Diagnosis Standard and National Lung Cancer Pathway must be comprehensively rolled-out across England
  • The wider healthcare community, including nurses and pharmacists, must be able to refer someone who they suspect might have lung cancer for a Chest X-ray
  • Clarity should be provided as to whose remit a lung cancer screening programme should fall under.  The roll out of lung health checks must also be supported by effective processes with robust, nationally centralised data collection, collation and evaluation programme

The report also includes examples of best practice – demonstrating how certain NHS Trusts are working to make the earlier diagnosis of lung cancer happen.

“There is no single ‘silver bullet’ when it comes to increasing rates of early diagnosis in lung cancer. However, through consistent, wide ranging and coordinated efforts from across the lung cancer community, we can reduce late diagnosis, particularly through emergency presentation, and see a difference in the outcomes achieved across the UK,” explained Mr Richard Steyn, chair of the UKLCC and Deputy Medical Director, University Hospitals Birmingham NHS Foundation Trust.

Source: UK Lung Cancer Coalition