As many as 56% of people in some parts of England are only diagnosed when they visit A&E

This article is more than 7 months old

This article is more than 7 months old



People with lung cancer are dying after being diagnosed late in A&E because their GP missed signs of the disease despite often repeated visits, experts have revealed.

As many as 56% of people in some parts of England who get lung cancer are only diagnosed when they visit A&E, according to a report by the UK Lung Cancer Coalition.

They are five times more likely to die within a year than those whose condition has been identified either by their GP or through the NHS cancer screening programme.

Family doctors often fail to diagnose cases of lung cancer until it is too late to treat effectively or miss them altogether, leading patients to seek help at A&E, the report says.

More than a third of lung cancer patients see their GP three or more times before being referred for tests. That is a key factor in the UK’s poor record, in international terms, at diagnosing the disease early.

Lung cancer is the third commonest form of cancer in the UK and the biggest cancer killer, claiming 35,000 lives a year.

“People diagnosed in A&E are dying as a result of delays in identifying their illness. Late diagnosis makes lung cancer harder to treat and is a major reason why we have such poor survival in the UK,” said Prof Mick Peake, chair of the coalition’s clinical advisory group.

It is “a travesty” that admission to hospital as a medical emergency is the single commonest way the disease is diagnosed, added Peake, who is also the clinical director of the Centre for Cancer Outcomes at University College Hospital London.

GPs’ failure to spot symptoms of lung cancer is only one reason for Britain’s low rate of early diagnosis and high rate of lung cancer mortality, Peake stressed.

However, he added: “There is good evidence that there are missed opportunities for earlier diagnosis in primary care and we strongly urge GPs to have a low threshold for doing a chest X-ray or CT scan in patients where there is any suspicion of lung cancer.”

Patients’ reluctance to have symptoms, such as a persistent cough, checked out can delay diagnosis too, especially those from poorer households and older people.

NHS data cited by Peake shows a postcode lottery in which Tower Hamlets in east London has the highest proportion of patients whose disease is diagnosed in A&E – 56.2% – closely followed by Manchester (56.1%) and Leeds south and east (54%).

More than 50% of patients are also diagnosed in A&E in Salford, Hull, South Tyneside and Sunderland.

In contrast, only 14.7% of sufferers in Guildford and Waverley in Surrey are diagnosed that way, with low rates also in Wokingham in Berkshire (15.7%) and Harrogate (16%).

Dr Moira Fraser-Pearce, director of policy, campaigns and influence at Macmillan Cancer Support, said that staff shortages in NHS cancer services and heavy workloads were exacerbating the complex reasons for the high level of diagnosis in A&E.

Macmillan has helped NHS England develop a new way of screening smokers and other high-risk patients for lung cancer by offering tests in trucks, often situated in supermarket car parks.

The NHS did not comment directly on the findings but a spokesperson said that: “The NHS is catching more cancers earlier when they are easier to treat, resulting in record lung cancer survival rates.”

Targeted lung health checks in locations such as supermarket car parks will detect “thousands more cases of cancer that might not have been detected otherwise, saving even more lives”, they added.

NHS England has pledged to diagnose three in four cases of cancer at an early stage by 2028. Currently 57% of lung cancers are diagnosed late, greatly reducing chance of survival.

• This article was amended on 31 January 2020. The original version said that the NHS had “declined to comment” on the findings of the report. This has been amended to make clear that, while it did not comment directly on the findings, the quotes that followed had been given in response.