Patients with emergency-diagnosed lung cancer report barriers to seeing their GP

The National Cancer Research Institute (NCRI)

Many patients whose lung cancer is diagnosed as an emergency in hospital reported difficulties in previously seeing their GP, according to research presented at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool today (Tuesday).

"It’s vital that patients recognise possible symptoms early on and are able to get them checked out quickly" - Dr Robert Rintoul

The study, carried out by researchers from the London Cancer Alliance (LCA)* and King’s College London **, investigated around 130 patients*** who were diagnosed with lung cancer after attending as an emergency at one of seven hospitals in south and west London.

Overall, nearly half of the patients reported that something had put them off going to the doctor, including difficulty making an appointment, not being able to see their usual doctor, not having confidence in the GP, and fear of what the doctor might find. About a fifth of all patients (18 per cent) said they had not realised that their symptoms were serious.

A fifth of all patients – who tended to be older, poorer and more fearful of what the doctor might find – delayed going to their doctor with their symptoms for more than 12 weeks.

Three-quarters of the patients had consulted their GP about their symptoms, and one fifth had seen a GP at least three times. Almost a quarter (23 per cent) of the patients had already been referred for hospital visits by a GP but many were admitted to hospital before the appointment because they were so unwell.

Lead study author Dr Thomas Newsom-Davis, LCA Acute Oncology Services pathway chair and consultant medical oncologist at Chelsea and Westminster Hospital, said: “These findings show that we need to work together to improve patient education, ensure that those with possible lung cancer can easily make an appointment to see their GP, and that patients are quickly seen in specialist lung cancer clinics.

“It’s important to pilot ways of ensuring that patients with possible symptoms of cancer can be seen in hospital before they get so ill that they are admitted as an emergency, for example, rapid-access diagnostic clinics.”

Lung cancer is the second most commonly diagnosed cancer in the UK. Around 43,500 people are diagnosed each year in the UK with around 35,400 UK deaths from lung cancer annually. Symptoms include a persistent cough, shortness of breath, chest pain and coughing up blood. Almost 40 per cent of patients with lung cancer in England are diagnosed as an emergency in hospital, and have poorer chances of survival.

Dr Robert Rintoul, Chair of NCRI’s Lung (Screening and Early Diagnosis) Clinical Studies Subgroup, said: “If lung cancer is diagnosed at an early stage, patients have a much higher chance of surviving the disease. Therefore it’s vital that patients recognise possible symptoms early on and are able to get them checked out quickly.

“This study provides valuable information to suggest ways to help ensure that far fewer patients have an emergency diagnosis of lung cancer, when their disease is likely to be more advanced and treatment is less likely to be successful.”


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Notes to Editor

* The London Cancer Alliance was established in 2011 as the integrated cancer system across west and south London. The LCA works collaboratively with 15 NHS member organisations, as well as two academic health science centres and the voluntary sector. It provides comprehensive, integrated cancer patient pathways and services to drive improvements in patient outcomes and experience.

** The study was part-funded by the London Cancer Alliance, the Department of Health, NHS England, and the Policy Research Unit in Cancer Awareness, Screening, and Early Diagnosis which receives funding from the Department of Health Policy Research Programme. It is a collaboration between researchers from seven institutions (Queen Mary University of London, UCL, King’s College London, London School of Hygiene and Tropical Medicine, Hull York Medical School, Durham University and Peninsula Medical School).

***The study looked at 133 patients whose lung cancer was diagnosed as part of an acute (unplanned) hospital attendance.