Lung cancer referrals dropped by two thirds during first wave of pandemic

One third of lung cancer patients have already died since the start of pandemic and the number of people urgently referred to a lung cancer specialist dropped by 75%, according to a new report by the UK Lung Cancer Coalition (UKLCC).

The new report, Covid-19 Matters, was compiled from a meeting and interviews with 45 of the UK’s leading lung cancer clinicians and key patient groups. It states that a reduction in referrals will lead to a backlog in outpatient appointments, surge in late-stage presentations and potentially hundreds of additional lung cancer deaths.

This will reverse the progress achieved in lung cancer survival over the last 10 to 15 years when between 2005 and 2015, five-year lung cancer survival almost doubled in England from 9% to 16%.

Guidance to stay at home with a cough has caused confusion

Professor Mick Peake OBE, chair of the UKLCC’s Clinical Advisory Group, said: “Fear of engaging with health services, halting the national programme of lung cancer screening pilots, and restricted access to diagnostic tests have all contributed to a drop in urgent two-week wait GP referrals in England.

“Government guidance to stay at home with a cough, a key symptom of lung cancer, has also caused further confusion.”

Lung cancer is the UK’s biggest cancer killer with 35,300 people dying each year. It accounts for more than a fifth of all UK cancer deaths (21%) – and lung cancer in never smokers is the 8th most common cause of cancer-related death in the UK. However, lung cancer can be cured if diagnosed early enough.

During first wave of pandemic, the risk of a patient dying after lung cancer surgery because they contracted Covid-19 around the time of surgery, increased from around 2% to up to 40-50%. In addition, over half (55%) of UK lung cancer specialist nurses or their team member were re-deployed or unable to work as a result of Covid-19.

Key recommendation for lung cancer care during the pandemic

The report lists a series of key recommendations, which include calling on Government and the new National Institute for Health Protection to:

• Rapidly launch a ‘Be Clear on Lung Cancer and Covid-19’ campaign to increase awareness of lung cancer symptoms and the public’s confidence in engaging with healthcare services early
• Quickly resume those local lung cancer screening pilot programmes that were already operational
• Urgently review isolation and visiting restrictions in hospital and palliative care settings to enable critically ill patients to see their families during the final phase of their lives
• Provide necessary funding to establish Community Diagnostic Hubs to reduce the risk of COVID-19 transmission and accelerate diagnostic turnaround time for lung cancer patients.

Mr Martin Grange, chair of the UKLCC, said: “The survival and quality of life of lung cancer patients will have been seriously and adversely affected as a result of Covid-19. Therefore, we urge everyone in the lung cancer community, be they clinicians, nurses, managers or policy makers to work together to help us recover the previous momentum in improving quality of care for people with lung cancer and continue to save lives.”