Get more people in Britain with symptoms of lung cancer to refer themselves for tests, experts say

Experts suggest that more people with lung cancer symptoms in Britain should be able to request tests themselves rather than waiting for their GP to ask for them.

Making it easier for people with symptoms to get chest X-rays could speed diagnosis and improve survival rates from the disease, they said.

“A diagnosis of lung cancer can be devastating, but catching it early can make all the difference,” said Dr Stephen Bradley, lead author of the study and a practicing GP in Leeds.

The analysis, published in the British Journal of General Practice, cited self-collecting chest X-rays based in Leeds and Greater Manchester. Patients with symptoms such as persistent coughing, fatigue and breathing difficulties can access radiology services directly under the schemes, with the report of their x-ray sent to their GP.

The analysis showed that people from less affluent groups and smokers are more likely to use the service. Previous research has shown that the percentage of diagnoses via self-referral (approximately 1%) is comparable to those referred by their GP in the conventional mannerwhich indicates that people are using the service appropriately. The wider rollout of these services “deserves urgent attention” given the “current challenges patients face in accessing primary care”, said the authors and the charity Roy Castle Lung Cancer Foundation.

Among other recommendations from experts is that messages about lung cancer symptoms should be designed to reach people who have never smoked. the symptoms of which may be less severeas well as current and former smokers.

“We need to make it easier for people with symptoms to get tests, like chest X-rays, and ways to raise awareness about the disease, including for people who haven’t smoked,” Bradley says.

“This is of course particularly relevant in Britain, as we have done outcomes that have been persistently poor compared to other high-income countries”, he added.

According to the NHS, more than 43,000 people are diagnosed with lung cancer every year in Britain. Smoking is the most common cause, accounting for approximately 70% of cases. Only a small but significant part – 14% – of those diagnosed with lung cancer have never smoked and this proportion has increased as the number of smokers in Britain has fallen. Treatment is more likely to be successful if cancer is caught early.

In June 2023, it was announced that a lung cancer screening program would be rolled out, targeting people aged 55 to 74 who are current or former smokers, and would be available across England by 2029. However, more than half of lung cancer cases develop. among people who are not eligible for screening and not everyone who is eligible chooses to participate.

Nick Whitehead, 58, from Newton Aycliffe, visited his GP a number of times with a persistent cough over the course of around 18 months but was never sent for a chest x-ray. He was eventually diagnosed with lung cancer two years later when he visited the emergency room after coughing up blood.

“There were a lot of opportunities for me to get diagnosed earlier,” Whitehead said. “I don’t think I was sent for tests because I was so fit.”

“As a diver I have good lung capacity so I was not short of breath, but given that we are constantly told that a persistent cough is a symptom of lung cancer, it is strange that I was not sent for a dive. At least an x-ray.”

Whitehead said he would have requested an X-ray himself if that had been an option.

Paula Chadwick, CEO of the Roy Castle Lung Cancer Foundation, said: “Far too often we hear stories of people like Nick who could have had lung cancer diagnosed earlier.

“It is imperative that we do everything we can to change this. We are making progress, largely through screening, with 76% of prisoners caught in the first and second phases.”

A spokesperson for the Department of Health and Social Care said: “Under this Government’s change plan to radically reform the NHS, we will fight cancer on all fronts – through prevention, diagnosis, treatment and research.

“We want to transform diagnostic services, including for lung diseases, so that we can identify more cases earlier and treat them faster. We will also deliver an additional 40,000 elective care appointments every week and invest an additional £1.5 billion in new surgical hubs and AI scanners.”