Experts demand ‘drastic’ improvement in UK lung cancer care

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.⁴ 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.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

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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