Early diagnosis difficult in lung cancer

NEARLY one in three UK lung cancer patients dies within three months of diagnosis despite having consulted numerous times with GPs prediagnosis, according to research published in the journal Thorax.

In the study, all cases of lung cancer diagnosed between 2000 and 2013 were extracted from The Health Improvement Network database – a total of 20,142 cases. Patients who died within 90 days of diagnosis were compared with those who survived longer. The research found that "those who died early consulted with primary care more frequently prediagnosis".

Survival rates among lung cancer patients are poor in the UK – with high early mortality – compared to other countries. The researchers from the University of Nottingham aimed to identify factors associated with early death and features of primary care that might contribute to late diagnosis.

Patients suffering early mortality went to see their GP five times on average in the few months before their diagnosis. Rates of chest X-ray varied widely but the odds of early death were highest in practices which requested more chest X-rays.

The researchers conclude: "Patients who die early from lung cancer are interacting with primary care prediagnosis, suggesting potentially missed opportunities to identify them earlier. A general increase in CXR requests may not improve survival; rather, a more timely and appropriate targeting of this investigation using risk assessment tools needs further assessment."

RCGP Cancer Lead, Dr Richard Roope, responded to the research, saying: "Lung cancer is notoriously difficult to diagnose in primary care, especially as a key symptom is coughing, which is present with numerous other conditions that GPs see every day.

"GPs are doing a good job of appropriately referring our patients that we suspect of having cancer and 75 per cent of patients found to have cancer are referred after only one or two GP consultations. And it is very encouraging that one-year survival rates for lung cancer are improving.

"Taking into account the global picture, GPs across the UK are doing very well considering the meagre resources available to us; funding for general practice is at an all time low, we have a chronic shortage of doctors, and access to CT scanners, that would help in the diagnosis of lung cancer, is very limited in UK primary care.

"Instead of criticising GPs, we need to invest in general practice to allow us to employ more GPs and support staff and to give GPs more access to technology that could ultimately save our patients’ lives."

Link

What characteristics of primary care and patients are associated with early death in patients with lung cancer in the UK?

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