‘Thousands’ of lung cancer cases going undiagnosed in England

Health officials are urging people to get worrying symptoms checked, after figures suggest that thousands of people in England could have undiagnosed lung cancer. 

NHS England figures show there have only been around three quarters of the suspected lung cancer referral patients that we would usually expect to see in secondary care between March and December 2020.  

Professor Peter Johnson, national clinical director for cancer at NHS England said that this means “a few thousand” fewer people have sought care. NHS England figures reveal around 2,400 fewer people started treatment for lung cancer in April to December 2020, compared with the same time in 2019.

NHS leaders have raised concerns that people are not coming forward for help because they do not want to put pressure on the health service, particularly at the start of the pandemic. Some of the symptoms of lung cancer, such as a persistent cough or breathlessness, can also indicate COVID-19 – perhaps making it hard for people to know how to interpret their symptoms. 

In September 2020, Cancer Research UK revealed that at least 14,000 fewer people than expected had been urgently referred for lung cancer tests in the first six months of the pandemic. And while more referrals were made   towards the end of 2020, the number of urgent suspected lung cancer referrals was still down 30% in December 2020 compared with December the previous year.  

“Cancer services have been hit hard by COVID-19, putting a lot of additional strain on people affected by cancer and their families. Referrals for suspected lung cancer have been slower to recover than urgent referrals for other cancer types, likely reflecting a drop off in people coming forward with symptoms. We’re hugely concerned for people who have symptoms but haven’t come forward.” – Michelle Mitchell, Cancer Research UK’s chief executive.

The NHS is open

Public Health England is urging anyone with unusual changes – including a cough lasting more than 3 weeks, persistent breathlessness, unexplained weight loss, coughing up blood or chest pain – to tell their doctor, because they will have more treatment options and a better chance of survival if they’re diagnosed early .

When diagnosed late, lung cancer has significantly worse survival compared to when it is caught at the earliest stages.

“We’ve worked really hard in the NHS, even while we’ve dealt with the coronavirus pandemic to make sure that cancer diagnosis and treatment has continued,” Professor Peter Johnson told Sky News. “We want to really make sure that if people have had a cough that’s gone on for more than 3 weeks if they’ve got any of the other worrying signs such as losing weight, coughing up blood or pain in the chest, that they really do come forward for hel p.”

Around 39,000 people in England are diagnosed with lung cancer each year, according to Public Health England figures. When diagnosed at is earliest stage, 59 in 100 people with lung cancer will survive their disease for 5 years or more, compared with 3 in 100 people who are diagnosed at the latest stage. 

Johnson told Sky News that NHS leaders know that people are worried about putting more of a strain on the NHS. “But it is very important that we catch lung cancer early because if we do catch it early that’s when we have a really good chance of curing it – if we find it at the earliest stage, more than half of people can actually be cured with something like an operation.”     

Cancer Research UK’s chief executive, Michelle Mitchell, said that even before the pandemic, lung cancer had stubbornly low survival. “We’ve more than doubled our spend since 2014 and built a thriving lung cancer research community in the UK. While our work will continue, we now face the real possibility that cancer survival could go backwards for the first time in decades. It’s therefore vital the Government protects cancer services and is clear the NHS is open for people with symptoms or who need tests or treatment.”

The campaign to encourage people to come forward by the NHS in England and Public Health England is being backed by ex-England cricket captain Sir Andrew Strauss, whose wife Ruth died from a rare form of lung cancer aged 46 in 2018.

 “It’s so important that if you notice any loved ones showing symptoms that could be a sign of cancer that you encourage them to contact their GP practice,” said Strauss.