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PATHWAY NAVIGATOR ‘CRITICAL’ TO CUTTING LUNG CANCER WAITING TIMES SAY EXPERTS

ADMINSTRATIVE ROLE CAN IMPROVE LUNG CANCER SURVIVAL – BUT FUNDING ‘CHALLENGING’

An admin role, described as ‘critical’ in helping to cut lung cancer waiting times and speeding up diagnoses, continues to face national funding challenges says a new report published today (18 October 2019) by the UK Lung Cancer Coalition (UKLCC).1

According to Pathways Matter – the first report to track uptake of NHS England’s National Optimal Lung Cancer Pathway [NOLCP] guidance and identify barriers – the appointment of a patient pathway navigator can help to more than double the number of lung cancer patients receiving treatment by day 49.

However, securing funding for the role remains ‘challenging’, according to interviews among 17 of the 19 Cancer Alliances.1

“The introduction of the patient pathway navigator has been singled out by our research as one of the most impactful and cost-effective changes made as part of NOLCP implementation,” says Professor Mick Peake, Chair of the UKLCC’s Clinical Advisory Group. “Yet our research shows not all Cancer Alliances or trusts have been able to secure funding to support the role – and, those that have, have either not been able to maintain the post or face uncertainty due to a lack of sustainable funding.”

The NOLCP was introduced by NHS England in 2017 to get lung cancer patients diagnosed faster and cut treatment times from the current standard of 62 days to 49 and is welcomed by the UKLCC.2

Despite improvements in quality of care and patient outcomes over the last ten years, around half (48%) of UK lung cancer patients are still diagnosed within the late stages of the disease – and a third are not being treated within the current 62-day cancer waiting time target.1

“Delays in timely diagnosis and associated patient access to treatment and care have been identified as contributing to the UK’s comparatively low lung cancer survival compared with the rest of Europe,” adds Professor Peake. “Our report highlights that appointing an administrator to manage the lung cancer pathway, which involves no clinical knowledge, is one of the important ways we can speed up the patient’s journey and improve lung cancer survival. It’s an absolute no-brainer.”

The cost of a lung cancer pathway navigator post ranges, on average, from just £20,000 to £25,000 per annum.3 As well as tracking appointments, rescheduling missed ones and chasing test results, pathway navigators provide an invaluable central point of contact for anxious patients and their families.1,4

Going forward, the report suggests more ‘economic’ modelling to assess the positive impact of the pathway navigator on patient survival.1

Other key recommendations within the report, also aimed at ensuring uptake of the NOLCP, are:1

  • Introducing a central PET-CT scan booking system to ensure timely access to the limited number of PET scanners in a given geographic area. Currently, the UK has less than half the number of PET scanners those available in other comparable, EU countries e.g. Italy has 185 PET-CT scanners compared to just 78 in the UK.
  • Direct referral by a radiologist of any suspicious chest x-rays for immediate, further investigation – rather than returning to the patient’s GP for next steps which can slow down the pathway.
  • Ensure chest X-rays and CT images are available before the diagnostic MDT meeting. This can reduce the patient’s pathway by as much as 14 days.
  • Speed up pathology times e.g. by introducing a simple colour-coding system to indicate which lung cancer samples are urgent. Some Cancer Alliances interviewed for the report identified significant backlogs on the system with one Alliance detecting tissue samples crossed up to 21 hands within the pathology pathway, thus increasing the risk of delays or samples being lost in the system.

“If we were to significantly increase the proportion of patients diagnosed at an early stage of their disease and at the same time ensured that every patient treated within the NHS received optimal and timely treatment, we believe that by 2025 we could see 25% of patients in the UK living to five years and beyond,” says Richard Steyn, chair of the UKLCC.

To download a copy of the Pathways Matter report, please visit www.uklcc.org.uk:

About the report

The development of the report was informed by comprehensive desk research and literature review of key websites, portals and publications. To assess the progress achieved by Cancer Alliances across the country as well as the barriers they encountered in the implementation of the NOLCP, semi-structured interviews were carried out with 17 out of 19 NHSE Cancer Alliances, as well as the following experts:

  • Professor Sir Mike Richards, former National Cancer Director and current Cancer Screening Programme Review Lead
  • Professor David Baldwin, Chair of NHS England’s Lung Clinical Expert Group
  • Lorraine Dallas, Director of Information, Prevention and Support at the Roy Castle Lung Cancer Foundation
  • Dr Martin Allan, Clinical Lead for the respiratory workstream, Getting It Right First Time (GIRFT)

The interviews were carried out from April to September 2019.

About lung cancer

Lung cancer remains the UK’s biggest cancer killer, with over 35,000 deaths each year.5 The disease accounts for over a fifth of all UK cancer deaths (21 per cent) and one in seven (13 per cent) of all new UK cancer cases. 5 It is reported that four people die from lung cancer in the UK every hour (nearly someone every 15 minutes).5 Although the majority of cases of lung cancer are caused by smoking, it is estimated that ‘Lung Cancer in Never Smokers’ is the 8th most common cancer in the UK6

About the UKLCC

The UKLCC is the UK’s largest multi-interest group in lung cancer and was established to help bring lung cancer out of the political, clinical and media shadow.  Its membership includes leading lung cancer experts, senior NHS professionals, charities and healthcare companies.  Its charity members include the British Lung Foundation, Tenovus Cancer Care, Macmillan Cancer Support, Marie Curie Cancer Care, Roy Castle Lung Cancer Foundation, and Cancer Black Care. Please visit www.uklcc.org.uk for more information and details of all of the UKLCC partners.

References

  1. Pathways Matter: A review of the implementation of the National Optimal Lung Cancer Pathway. UK Lung Cancer Coalition, October 2019. Available at uklcc.org.uk
  2. National Optimal Lung Cancer Pathway – updated 2018? https://www.england.nhs.uk/wp-content/uploads/2018/04/implementing-timed-lung-cancer-diagnostic-pathway.pdf
  3. Based on interviews with Cancer Alliances and access to recruitment websites
  4. NHS England, Patient Navigators, accessible at: https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2016/12/patient-navigators.pdf
  5. ‘Lung cancer in never-smokers: a hidden disease’ accessed at: https://journals.sagepub.com/doi/full/10.1177/0141076819843654

For further information

Please contact, Lynsey Conway, UKLCC on 07778 304233

Dr Matt Evison talks about the award-winning RAPID programme

Lung cancer is the biggest cause of premature death in Greater Manchester. The Multi-Disciplinary Lung Cancer Team, led by Dr Richard Booton at the North West Lung Centre, Wythenshawe Hospital, has therefore spent the last two years dedicated to transforming its lung cancer pathway.

This has involved the complete redesign of the specialist and complex service, to what is now known as the RAPID (Rapid Access to Pulmonary Investigation and Diagnosis) Programme.

Lung cancer diagnosis is complex and requires multiple tests.  The current cancer pathway targets set a maximum waiting time of 62-days from patient referral to treatment – and also sets a target of 85% compliance. Yet, across the UK these targets are not being met.

The core aim of the RAPID Programme was therefore to speed up access to diagnostics, eliminate unnecessary delays, and improve the experience and quality of care for patients with suspected lung cancer – potentially resulting in improved survival.  Our overarching vision was to provide the type of care we would expect for our own families and loved ones.

Central to the RAPID Programme is next-day access to CT imaging (following a referral for suspected lung cancer) – together with same-day hot reporting and clinical review. In patients that do not have lung cancer, this significantly reduces the anxiety of ‘not knowing’. For those in whom lung cancer is suspected we can immediately commence a protocolised investigation pathway consisting of test bundles.  This requires a dedicated patient navigator to coordinate appointments from multiple departments – which involved a great deal of collaborative working and good communication. Daily percutaneous image guided biopsy and daily EBUS services maintain the ‘next day ethos’ of the service. We also undertake a daily virtual board round of all patients on the pathway so that any test results are viewed and timing of MDT discussion and follow-up is appropriately planned. However, setting up the Programme was not without its challenges. The Programme has no control over access to PET scanning and lack of PET provision on-site prevented same-day planning for necessary tests.

The introduction of the RAPID programme has dramatically enhanced the efficiency of the front-end of the lung cancer pathway. Prior to this, of those in the 2-week referral pathway, 0% of patients had their CT scan within four days; 27% had a CT scan within seven days and 74% within 14 days.  Following the implementation of the RAPID Programme, 78% of patients now have their CT scan within four days; 92% within seven days and 99% within 14 days.

In addition, we have also shortened the diagnostic pathway for lung cancer such that 8%, 42%, and 77% of referrals are discussed at MDT – with completed investigations by day 7, 14 and 21, respectively.  This compares with 0%, 8% and 17% prior to the introduction of the RAPID Programme. As a result, 40% of patients received surgery within 14 days of the MDT meeting and we are now working to establish appropriate working practices within thoracic surgery and medical oncology to improve this even further.

With 93% of patients now rating the service delivered through the RAPID Programme as eight out of ten or better, this has confirmed a real improvement in care and an accelerated service for the benefit of patients and their families.

For more information about the RAPID programme and its successes, read our Millimetres Matter report at: http://uklcc.org.uk/our-reports/ or contact Dr Matt Evison  matthew.evison@mft.nhs.uk or Dr Richard Booton richard.booton@mft.nhs.uk directly.

UK PATHOLOGY SERVICES ‘PATCHY’ SAY EXPERTS

Limitations in Rapid Access to High Quality Molecular Diagnostic Tests Denying Some Lung Cancer Patients Best Possible Treatments

A new report being launched at the British Thoracic Oncology Group (BTOG) Annual Conference today (Dublin, 25th January 2019) says UK pathology services are ‘patchy’ and the NHS has been ‘slow to respond’ to the rapid advances in molecular diagnostics.1

New treatments for lung cancer based on molecular tests are emerging rapidly and leading to improvements in survival for many patients. However, limitations in rapid access to high quality tests are denying some lung cancer patients access to the most accurate diagnosis and the best possible treatments.  Currently, the UK has among the worst five-year survival rates for lung cancer across Europe.2

Despite the recent launch of seven NHS genomic testing labs across England3 – and the Government’s ambition to increase the proportion of early cancers diagnosed by 20284 – currently only three percent of pathology departments have enough staff; there is a wide variation in the quality of tissue samples being received by pathology labs; and there are significant delays in turning around test results.1

Among its detailed recommendations, the UK Lung Cancer Coalition (UKLCC) is calling for a national, molecular diagnostics quality assurance programme and increases in funding to address the critical workforce issues in cellular pathology.1

Molecular diagnostics is central to lung cancer diagnosis and treatment. If we are to deliver a world-class lung cancer service more needs to be done to ensure timely and rapid access diagnostic testing for lung cancer patients, wherever they live in the UK,” says Professor Mick Peake, Clinical Lead, UKLCC; Clinical Director, Centre for Cancer Outcomes, Cancer Collaborative, UCLH; Emeritus Consultant and Honorary Professor of Respiratory Medicine, University of Leicester.

The report ‘Molecules matter: Turning the science of molecular diagnostics in lung cancer into a practical service for all patients’ is the culmination of a meeting comprising a select group of highly qualified molecular diagnostic and lung cancer experts.1 It is a companion report to ‘Millimetres Matter: Implementing the National Optimal Lung Cancer Pathway’ which was launched in November 2018.5

“The UKLCC is committed to doubling five-year lung cancer survival to 25 percent by 20256 – and universal and rapid access to high quality molecular diagnostics is a vital element in our ability to reach that target”, adds Professor Peake.

To access the report, visit: http://uklcc.org.uk/wp-content/uploads/2019/01/Molecules-Matter.pdf

About lung cancer

Lung cancer remains the UK’s biggest cancer killer, with over 35,000 deaths each year.7 The disease accounts for over a fifth of all UK cancer deaths (21 per cent) and one in seven (13 per cent) of all new UK cancer cases. It is reported that four people die from lung cancer in the UK every hour (nearly someone every 15 minutes).7 Although the majority of cases of lung cancer are caused by smoking, it is estimated that ‘Lung Cancer in Never Smokers’ is the 8th most common cancer in the UK.8

About genomics and molecular diagnostics

Once a patient has a tumour, the medical team can use a range of different tests and scans to diagnose the cancer.

Immuno-histochemistry (IHC) tests are commonly used to deliver an initial diagnostic report.  These consist of staining a tissue sample, which is then examined under a microscope.  IHC testing has a role in diagnosis, prognosis and in identifying markers that inform treatment options.

Molecular diagnostics is a specific part of laboratory medicine or clinical pathology which uses the techniques of molecular biology to, diagnose disease, predict disease course, select treatments and monitor the effectiveness of treatments. Molecular testing can be done as single gene abnormality testing which focuses on testing for unique, identified gene alterations that have been correlated with an effective targeted therapy (one-gene, one-test) or with panel testing which look at several different gene alterations.

Since the first sequencing of the human genome, it has become possible to understand a wealth of information about cancers that can help to guide treatment with personalised medicines.

About the UKLCC

The UKLCC was set up in 2005 with the founding ambition to tackle poor lung cancer survival outcomes and, specifically to double five-year survival by 2015, which has now effectively been achieved (9 per cent in 2005 to 16 per cent in England).9 The UKLCC is now committed to re-double five-year lung cancer survival to 25 percent by 2025.6

The UKLCC is the UK’s largest multi-interest group in lung cancer and was established to help bring lung cancer out of the political, clinical and media shadow.  Its membership includes leading lung cancer experts, senior NHS professionals, charities and healthcare companies.  Its charity members include the British Lung Foundation, Tenovus Cancer Care, Macmillan Cancer Support, Marie Curie Cancer Care, Roy Castle Lung Cancer Foundation, and Cancer Black Care. Please visit www.uklcc.org.uk for more information and details of all of the UKLCC partners.

References

  1. Molecules matter: Turning the science of molecular diagnostics in lung cancer into a practical service for all patients. UK Lung Cancer Coalition. January 2019. Accessible at: uklcc.org.uk/our-reports/
  2. London School of Hygiene and Tropical Medicines: Cancer Survival Group, CONCORD Programme, via: http://csg.lshtm.ac.uk/research/themes/concord-programme/ Accessed November 2018
  3. NHS England, Genomic Laboratory Hubs. October 2018. Available via: https://www.england.nhs.uk/genomics/genomic-laboratory-hubs/
  4. The NHS Long Term Plan. NHSE January 2019. Available via: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf
  5. Millimetres Matter: Implementing the National Optimal Lung Cancer Pathway. UK Lung Cancer Coalition. November 2018. Accessible at: uklcc.org.uk/our-reports/
  6. 25 by 25: A Ten-Year Strategy to Improve Lung Cancer Survival Rate. UK Lung Cancer Coalition October 2016. Accessible at:  uklcc.org.uk/our-reports/
  7. Walters S, Benitez-Majano S, Muller P, et al., ‘Is England closing the international gap in cancer survival?’ Br J Cancer, 4 S 2016, doi: 10.1038/bjc.2015.265. Accessed September 2016 via: http://www.nature.com/ bjc/journal/vaop/ncurrent/pdf/ bjc2015265a.pdf

For further information, please contact: Lynsey Conway, 07778 304233.

DELAYS IN LUNG CANCER TREATMENT ‘CANNOT BE TOLERATED’ SAY EXPERTS

Three out of four patients diagnosed ‘too late’

Variations in lung cancer care ‘cannot be tolerated’ and many people face ‘unwarranted’ delays in treatment, says a new report published today (22 November 2018) by the UK Lung Cancer Coalition (UKLCC).1

According to the report, just a quarter (27%) of lung cancer patients in England receive an early diagnosis (stage I or II) – and only around three quarters of lung cancer patients (72.6%) get treated within the current 62-day national cancer waiting time standard.1

“Three out of four people with lung cancer are diagnosed too late to be suitable for potentially curative treatment” says Professor Mick Peake (Chair), Clinical Director, Centre for Cancer Outcomes, Cancer Collaborative, UCLH and Chair of the UKLCC’s Clinical Advisory Group. “Unwarranted delays in treatment, even at the early stages, can allow a tumour to grow by just a few millimetres which can have a dramatic effect on someone’s chance of survival.”

Lung cancer is the biggest cancer killer in the UK for both men and women – with five-year survival rates consistently lagging behind many other countries in Europe.  England currently ranks 26th out of 29 countries.3

Titled ‘Millimetres Matter’, the UKLCC report is calling for local cancer services to implement the National Optimal Lung Cancer Pathway (NOLCP), an NHS England initiative which advocates a standardised care pathway for lung cancer patients, wherever they live, as well as faster access to diagnostic tests and treatment and reduced waiting times.4

The UKLCC believes putting the NOLCP into action, will help achieve its ambition of boosting five-year UK lung cancer survival to 25% by 2025.* 

Patients diagnosed at the earliest stage of lung cancer are almost five times more likely to survive a year from diagnosis than those diagnosed in the later stages. 1

Currently, lung cancer patients in the UK are diagnosed with more advanced disease than many other countries and a third first reach specialist care following an emergency admission to hospital.5

Studies show there is a 16% increase in mortality if the time from lung cancer diagnosis to having surgery is more than 40 days – putting lives unnecessarily at risk.1

“A delayed diagnosis means patients having their worst fears dragged out, with thousands of people being left in an appalling state of limbo,” adds Richard Steyn, Consultant Thoracic Surgeon; Deputy Medical Director, University Hospitals Birmingham NHS Foundation Trust; Honorary Associate Professor, University of Warwick and Chair of the UKLCC. “Despite improvements, we are still failing patients in England and the rest of the UK. More must be done to address the poor lung cancer survival in this country.  Therefore, it is imperative that all hospital trusts adopt the National Optimum Lung Cancer Pathway.”

In addition to urging adherence to the National Optimal Lung Cancer Pathway, the UKLCC’s report sets out a series of practical, real-life examples and case studies of how NHS trusts are already implementing elements of the NOLCP. These include a centralised booking system for diagnostic tests; appointment of a treatment pathway coordinator; inter-trust lung cancer referrals and providing patient travel for long-distance hospital appointments.1

To access the report, visit:  http://uklcc.org.uk/wp-content/uploads/2018/11/UKLCC-Millimetres-Matter-2.pdf

UK Lung Cancer Coalition welcomes results on ‘Be clear on Cancer’ initiative

The UK Lung Cancer Coalition (UKLCC) today (12th March 2018) welcomes the publication of an evaluation report by Public Health England and the National Cancer Registration and Analysis Service (NCRAS) on the impact of the Be Clear on Cancer lung campaigns which ran from 2011 to 2014.1

Be Clear on Cancer is now in its eighth year, and has become a well-established, award-winning brand, working to improve cancer outcomes and reduce health inequalities. Early diagnosis is crucial to improving outcomes from cancer and other serious diseases. Be Clear on Cancer is part of the national drive to tackle cancer, contributing towards making earlier diagnosis a reality for the thousands of people diagnosed with cancer each year.

“While the results of the report are complex, what is clear is that these campaigns have raised awareness of the symptoms of lung cancer, prompting people to see their GPs, triggering increases in referrals for suspected cancer”, say Professor Mick Peake, author of the report, Clinical Lead for Early Diagnosis, NCRAS, and Chair of the UKLCC’s clinical advisory group.  “This has led to a shift in the proportion of patients diagnosed with earlier stage disease, allowing them the possibility of securing more effective treatment.”

Lung cancer kills more people than any other cancer. In 2015 it accounted for 21% of all cancer deaths in England with 28,565 deaths and 36,637 new patients being diagnosed with the disease. Late presentation is a major problem and in 2015 over 70% of patients had essentially incurable disease by the time they reached specialist care.1

The UK Lung Cancer Coalition (UKLCC) is currently calling on governments, commissioners and the health care community to work together to raise five-year lung cancer survival rates to 25 per cent by 2025 across the UK.2

To access the report, click here: http://www.ncin.org.uk/cancer_type_and_topic_specific_work/topic_specific_work/be_clear_on_cancer/

Raising the UK Lung Cancer Survival Ambition

For the last ten years, lung cancer has consistently been the UK’s biggest cancer killer. 1,2 In 2014 alone, it was the cause of almost 35,900 deaths,3 which is more than breast4 and bowel cancers combined.5 

The UK Lung Cancer Coalition (UKLCC) was set up in 2005 with the founding ambition to tackle poor lung cancer survival – and specifically to double five-year survival by 2015.  As a result of efforts to improve long-term survival by the UK nations over recent years, estimates now suggest that the UKLCC’s original vision has effectively been met in England6 – with improvements also seen in Scotland,7 Wales8 and Northern Ireland.9 

Yet, despite significant progress being made, it’s vital we do not become complacent. Compared to other major common cancers, lung cancer is still not prioritised as it should be – resulting in wide variations in care10 – and UK five-year survival rates fall severely behind other developed European countries.11 

Consequently, our latest report, 25 by 25: a ten-year strategy to improve lung cancer survival rates, calls for a redoubling of effort by governments and the lung cancer community to improve outcomes for patients even further. As the title suggests, our latest ambition is to increase five-year lung survival rates across the UK to 25 per cent within the next decade. If achieved, from 2025 onwards this will result in at least 4,000 deaths prevented within five years of diagnosis each year – or over UK 11,000 deaths prevented per year overall 

To determine how to meet this goal, the UKLCC sought to explore not just the existing evidence but also the opinions of those who face up to lung cancer every day, launching a number of UK-wide surveys within the lung cancer community, as well as among patients. 

Based on these insights, this report contains a series of UK-wide principles as well as specific set of actions to improve five-year survival rates in England, Northern Ireland, Scotland and Wales.  Key recommendations include the establishment of a UK-wide taskforce in line with European best-practice; launching pilot data programmes to assess and address the significant variation in five-year lung cancer survival; a comprehensive audit to improve waiting times; and the introduction of UK-wide screening for all at-risks groups.

We hope very much that the launch of this report helps breathe new energy and enthusiasm into a cancer community which recognises that there is much more work to be done.  A lung cancer diagnosis should not be a death sentence and we hope that governments, policy makers and health professionals in England, Scotland, Wales and Northern Ireland can support the UKLCC’s ‘25 by 25’ ambition.  

 

Mr Richard Steyn

Chair of the UKLCC

Consultant Thoracic Surgeon and Associate Medical Director, Surgery, Heart of England NHS Foundation Trust.  

 

1.Office of National Statistics, Cancer Incidence and Mortality, 2007-09, March 2012. Accessed September 2016 via: http:// webarchive.nationalarchives.gov.uk/20160105160709/http://www.ons.gov. uk/ons/rel/cancer-unit/cancer-incidenceand-mortality/2007-2009/cancer-incidenceand-mortality–tables-and-charts.xls  

2.Cancer Research UK, Cancer Mortality for Common Cancers. Accessed September 2016 via: http://www.cancerresearchuk.org/ health-professional/cancer-statistics/mortality/common-cancers-compared#headingZero

3.Cancer Research UK, Lung Cancer Mortality Statistic., Accessed September 2016 via: http://www.cancerresearchuk.org/healthprofessional/cancer-statistics/statistics-bycancer-type/lung-cancer/mortality

4.Cancer Research UK, Bowel Cancer Statistics. Accessed September 2016 via: http://www.cancerresearchuk.org/healthprofessional/cancer-statistics/statistics-bycancer-type/breast-cancer 

5.Cancer Research UK, Breast Cancer Statistics. Accessed September 2016 via: http://www.cancerresearchuk.org/healthprofessional/cancer-statistics/statistics-bycancer-type/bowel-cancer

6.Walters S, Benitez-Majano S, Muller P, et al., ‘Is England closing the international gap in cancer survival?’ Br J cancer, 4 S 2016, doi: 10.1038/bjc.2015.265. Accessed September 2016 via: http://www.nature.com/ bjc/journal/vaop/ncurrent/pdf/ bjc2015265a.pdf

7.ISD Scotland, Cancer Statistics. Accessed September 2016 via: http://www.isdscotland.org/Health-topics/cancer/cancer-Statistics/ Lung-cancer-and-Mesothelioma/#lung

8.Welsh cancer Intelligence and Surveillance Unit, Cancer in Wales 2001 -2014. Accessed September 2016 via: http://www.wcisu. wales.nhs.uk/opendoc/257912 

9.Northern Ireland Cancer Registry, Lung, Trachea, Bronchus: Mortality 1993-2013. Accessed September 2016 via: http://www.qub. ac.uk/research-centres/nicr/cancerInformation/official-statistics/bySite/ lungTracheabronchus/ 

10.Royal College of Physicians, National Lung Cancer Audit (2014 audit period), 2015. Accessed September 2016 via: https://www.rcplondon.ac.uk/file/2280/ download?token=IdceLmHa

11.R De Angeli et al, ‘Cancer survival in Europe 1999–2007 by country and age: Results of EUROCARE-5—A population-based study’, Lancet Oncology 2014, 15(1), pp.23-34

 

Experts demand ‘drastic’ improvement in UK lung cancer care

Boosting five-year lung cancer survival to 25% will save over 11,000 UK lives 

Experts are calling for a “drastic improvement” in lung cancer care in order to improve poor UK survival rates, says a new report published today (19th October 2016).1 

The UK Lung Cancer Coalition (UKLCC) wants governments, commissioners and the health care community to work together to raise five-year lung cancer survival rates to 25 per cent by 2025 across the UK.1 If achieved, from 2025 onwards this will result in at least 4,000 deaths prevented within five years of diagnosis each year – or over UK 11,000 deaths prevented per year overall.2  

“The highest five-year survival rate across the UK is currently predicted to be 16 per cent in patients diagnosed in 2013 in England,3 which is effectively double what it was in 2005 when the UKLCC was established,” says Professor Mick Peake, Clinical Lead for Early Diagnosis (National Cancer Analysis and Registration Service) and Chair of the UKLCC’s clinical advisory group.                                      

“However, we cannot be complacent. Lung cancer survival rates across the UK still lag severely behind our European counterparts and compare poorly with other major common cancer types,” he adds. 

The new report ’25 by 25: a ten-year strategy to improve lung cancer survival rates’, provides invaluable insights from both patients and health care professionals (HCPs) regarding the perceived barriers to five-year survival – and sets out 20 key recommendations on how to overcome them.1 

According to the report, nearly two-thirds (65 per cent) of HCPs respondents in a UKLCC survey, believe early-stage diagnosis to be the most important factor for improving five-year survival rates – yet only 27 per cent of patients questioned said they visited their doctor because they recognised the signs and symptoms of lung cancer. In addition, 84 per cent of HCPs believe regional inequalities in health and care services have a significant impact on lung cancer survival rates across the UK. *

In order to deliver the UKLCC’s ‘25 by 25’ ambition, the report calls for a number of key actions, which include:-

•Governments across the UK to prioritise the improvement of lung cancer survival in any future plans or strategies relevant to the delivery of broader health, respiratory and/or cancer services

•The establishment of a UK-wide taskforce to achieve ‘25 by 25’ in line with European best practice

•The launch of pilot data programmes to assess and address the significant variation in five-year lung cancer survival across the UK

•The introduction of UK-wide screening for all at-risk groups, informed by the results of the NELSON lung cancer screening study, which are due in 2017  

•The 62-day waiting time target to start cancer treatment has been breached consistently for the past two years: The UKLCC is calling for a comprehensive audit to improve cancer waiting times.

“This report breathes new energy and enthusiasm into a lung cancer community which recognises that there is much more work to do.  A lung cancer diagnosis should not be a death sentence. We hope that government policy makers and health service professionals in England, Scotland, Wales and Northern Ireland can support the UKLCC’s ‘25 by 25’ ambition,” says Mr Richard Steyn, Chair of the UKLCC, and Consultant Thoracic Surgeon and Associate Medical Director, Surgery, Heart of England NHS Foundation Trust.  

Lung cancer remains the UK’s biggest cancer killer; it kills over 35,000 people each year, which is more than breast, bowel, bladder and uterine cancer combined.4The disease accounts for nearly a quarter of all UK cancer deaths (22 per cent) and one in seven (13 per cent) of all new UK cancer cases.5 It is reported that four people die from lung cancer in the UK every hour (someone every 15 minutes).6 More women die from lung cancer than breast cancer7and despite, being labelled a ‘smoker’s disease’, one in eight people with lung cancer have never smoked.8

-ends-

Note to editors:

The UKLCC was set up in 2005 with the founding ambition to tackle poor lung cancer survival outcomes and, specifically to double five-year survival by 2015, which has now effectively been achieved (9 per cent in 2005 to 16 per cent in England).3 The UKLCC is the UK’s largest multi-interest group in lung cancer and was established to help bring lung cancer out of the political, clinical and media shadow.  Its membership includes leading lung cancer experts, senior NHS professionals, charities and healthcare companies.  Its charity members include the British Lung Foundation, Tenovus Cancer Care, Macmillan Cancer Support, Marie Curie Cancer Care, Roy Castle Lung Cancer Foundation, and Cancer Black Care. Please visit www.uklcc.org.uk for more information and details of all the UKLCC partners.

*There are currently wide variations in lung cancer treatment and care across the UK such as:-

•Five-year survival rates for breast cancer are still up to ten times higher than lung cancer five-year survival rates in England and Wales. 

•The percentage of lung cancer patients receiving anticancer treatment in England varied by hospital trust from 32 per cent to 83 per cent in 2014

•The proportion of people with early stage lung cancer varies from 33 to 63 per cent across England and Wales and rates for chemotherapy vary from 46 to 63 per cent. 

•Patients receiving active treatment under the age of 65 in England is 77 per cent, compared to 20 per cent for people over 80 – nearly four times higher. 

•Access to a lung cancer nurse specialist varied from 33.7 per cent to 100% across England in 2014

•Active treatment for lung cancer in England has fallen from 60.2 per cent to 57.6 per cent. 

•The number of men diagnosed with lung cancer in the UK has decreased by 11 per cent – yet increased in women by 17 per cent over the last ten years.

•There is variation in access to radiotherapy services and the percentage of Scottish patients receiving any anti-cancer treatment for lung cancer has decreased from 64 to 61 per cent.  

•Around 940 people die every year from lung cancer in Northern Ireland – three times the number of deaths from breast cancer.1,9

 

References:

1.’25 by 25: a ten-year strategy to improve lung cancer survival rates’. October 2016. Accessible at: www.uklcc.org.uk

2.See methodology below 

3.Walters S, Benitez-Majano S, Muller P, et al., ‘Is England closing the international gap in cancer survival?’ Br J Cancer, 4 S 2016, doi: 10.1038/bjc.2015.265. Accessed September 2016 via: http://www.nature.com/ bjc/journal/vaop/ncurrent/pdf/ bjc2015265a.pdf

4.Cancer Research UK mortality statistics accessed at: http://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/common-cancers-compared#heading-Zero

5.Cancer Research UK statistics accessed at http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer?script=true#heading-Zero

6.Cancer Research UK statistics accessed at: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/mortality#undefined

7.Accessed at: http://www.nhs.uk/Livewell/Lungcancer/Pages/Womenandlungcancer.aspx

8.Be clear on cancer accessed at: http://www.nhs.uk/be-clear-on-cancer/lung-cancer/about

9.Ten years on in lung cancer: the changing landscape of UK’s biggest cancer killer. Report by UK Lung Cancer Coalition. October 2015. Accessible at: www.uklcc.org

 

How we reached the lives saved figure: 

•Take the number of cases of lung cancer in each devolved nation using incidence rates from 2013 – available here 

•Calculate what x% of the number of cases is in order to discover how many are currently surviving for over five years (where x is the five-year survival rate in that nation using statistics from: England here, Wales here Scotland here and Northern Ireland here) 

•Compare the resulting number with what it would be if survival rates were 25% in the same nation

For further information, please contact:-

Lynsey Conway on 07778 304233 or email@lynseyconway.co.uk or info@uklcc.org.uk    

 

How can we improve Lung Cancer Survival? New nationwide survey seeks views from UK Health Professionals

 

A new survey, launched today (18th May 2016) by the UK Lung Cancer Coalition (UKLCC), will aim to seek views from UK health professionals on how to improve five-year lung cancer survival rates over the next ten years.

“Despite the UKLCC being on track to meet its founding ambition of doubling five-year survival rates between 2005 and 2015*, lung cancer survival rates still compare poorly with other major cancers,” says Mr Richard Steyn, Chair of the UKLCC, and Consultant Thoracic Surgeon and Associate Medical Director, Surgery, Heart of England NHS Foundation Trust.

“We want to hear from healthcare professionals on how they believe we can further eliminate the barriers to poor survival and quality of life, right from the point of diagnosis.”  

The UK survey will be anonymous and open to all health professionals working across the lung cancer pathway.

Among the key questions included in the survey are:  What is the greatest challenge within your Multi-Disciplinary Team (MDT) in improving survival rates?  Should the UK introduce a national screening programme for lung cancer?  And to what extent do you believe regional inequalities in NHS services have an impact on lung cancer survival rates? 

“Although lung-cancer survival rates in Britain are improving, they remain unacceptably poor, compared with much of the rest of Europe and the United States.  It’s imperative that the UK clinical community continue to work together and continue to scrutinise commissioners and policy-makers,” says Professor Mick Peake, Professor of Respiratory Medicine, University of Leicester; clinical lead, National Cancer Analysis and Registration Service, Public Health England; and head of the UKLCC’s Clinical Advisory Group. 

The survey closing date is 27 June 2016 and the results of the research will culminate in a UK-wide report later this year. 

The survey can be accessed at: www.uklcc.org.uk.  Paper copies will also be available via the UKLCC’s Secretariat.

-ends-

Note to editors

* Predicted five-year survival rate of patients diagnosed in England in 2013 is now almost double (16 per cent) what it was ten years ago (9 per cent).1

However, lung cancer remains the UK’s biggest cancer killer; it kills over 35,000 people each year, which is more than breast, bowel, bladder and uterine cancer combined.2 The disease accounts for nearly a quarter of all UK cancer deaths (22 per cent) and one in seven (13 per cent) of all new UK cancer cases.3 It is reported that four people die from lung cancer in the UK every hour (someone every 15 minutes).4 Despite, being labelled a ‘smoker’s disease’, one in eight people with lung cancer have never smoked.5

The UKLCC is the UK’s largest multi-interest group in lung cancer and was established to help bring lung cancer out of the political, clinical and media shadow and improve one-year and five-year survival rates – which has been achieved.  Its membership includes leading lung cancer experts, senior NHS professionals, charities and healthcare companies.  Its charity members are the British Lung Foundation, Tenovus Cancer Care, Cancer Research UK, Macmillan Cancer Support, Marie Curie Cancer Care, Roy Castle Lung Cancer Foundation, and Cancer Black Care.

Please visit www.uklcc.org.ukfor more information and details of all the UKLCC partners.

References:

  1. Walters S, Benitez-Majano S, Muller P, et al., ‘Is England closing the international gap in cancer survival?’ British Journal of Cancer, 4 August 2015.  Available online via: http://www.nature.com/bjc/journal/vaop/ncurrent/pdf/ bjc2015265a.pdf
  2. Cancer Research UK, ‘Cancer mortality for common cancers’, 2012.  Available online via:  http://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/common-cancers-compared#heading-Zero
  3. Cancer Research UK, ‘Lung cancer statistics’, 2013.  Available online via:  http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer?script=true#heading-Zero
  4. Cancer Research UK, ‘Lung cancer mortality statistics’, 2012.  Available online via: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/mortality#undefined
  5. NHS Choices, ‘About lung cancer’, accessed May 2016.  Available online via:http://www.nhs.uk/be-clear-on-cancer/lung-cancer/about

For further information, please contact:-

Lynsey Conway on 07778 304233 or email@lynseyconway.co.uk or info@uklcc.org.uk 

New National Lung Cancer Patient Survey Launched

A UK survey to gather the experiences of lung cancer patients, including their families and carers, is launched today (18th May 2016) by the UK Lung Cancer Coalition (UKLCC).

Among its objectives, the research hopes to uncover what really matters to people living with lung cancer – and what more can be done to improve their experiences of treatment and care from the point of diagnosis – in order to increase their chance of survival and having a good quality of life. 

“Despite the UKLCC being on track to meet its founding ambition of doubling five-year survival rates between 2005 and 2015,1* lung cancer survival rates still compare poorly with other major cancer types,” says Mr Richard Steyn, Chair of the UKLCC, and Consultant Thoracic Surgeon and Associate Medical Director, Surgery, Heart of England NHS Foundation Trust.

“We want to further eliminate barriers to poor survival and quality of life in the UK.  Only by listening to people living with lung cancer can we hope to succeed.” 

Lung cancer remains the UK’s biggest cancer killer; it kills over 35,000 people each year, which is more than breast, bowel, bladder and uterine cancer combined.2  The disease accounts for nearly a quarter of all UK cancer deaths (22 per cent) and one in seven (13 per cent) of all new UK cancer cases.3  It is reported that four people die from lung cancer in the UK every hour (someone every 15 minutes).4 Despite, being labelled a ‘smoker’s disease’, one in eight people with lung cancer have never smoked.5

The survey will be completely confidential and can be accessed at: www.uklcc.org.uk.  Paper copies of the survey can also be downloaded from the website, or requested from selected lung cancer nurse specialists.

The survey closing date is 27 June 2016 and the results of the research will culminate in a UK-wide report later this year. 

-ends-

Note to editors

*Predicted five-year survival rate of patients diagnosed in England in 2013 is now almost double (16 per cent) what it was ten years ago (9 per cent).1

The UKLCC is the UK’s largest multi-interest group in lung cancer and was established to help bring lung cancer out of the political, clinical and media shadow and improve one-year and five-year survival rates – which has been achieved.  Its membership includes leading lung cancer experts, senior NHS professionals, charities and healthcare companies.  Its charity members are the British Lung Foundation, Tenovus Cancer Care, Cancer Research UK, Macmillan Cancer Support, Marie Curie Cancer Care, Roy Castle Lung Cancer Foundation, and Cancer Black Care.

Please visit www.uklcc.org.ukfor more information and details of all the UKLCC partners.

References:

  1. Walters S, Benitez-Majano S, Muller P, et al., ‘Is England closing the international gap in cancer survival?’ British Journal of Cancer, 4 August 2015.  Available online via: http://www.nature.com/bjc/journal/vaop/ncurrent/pdf/ bjc2015265a.pdf
  2. Cancer Research UK, ‘Cancer mortality for common cancers’, 2012.  Available online via:  http://www.cancerresearchuk.org/health-professional/cancer-statistics/mortality/common-cancers-compared#heading-Zero
  3. Cancer Research UK, ‘Lung cancer statistics’, 2013.  Available online via:  http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer?script=true#heading-Zero
  4. Cancer Research UK, ‘Lung cancer mortality statistics’, 2012.  Available online via: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/mortality#undefined
  5. NHS Choices, ‘About lung cancer’, accessed May 2016.  Available online via:http://www.nhs.uk/be-clear-on-cancer/lung-cancer/about

For further information, please contact:-

Lynsey Conway on 07778 304233 or email@lynseyconway.co.uk or info@uklcc.org.uk

Contact

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Tel: 01675 477605
Email: Info@uklcc.org.uk
Media enquiries only: Call 07778 304233

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