21st October 2020

75% drop in people referred to lung cancer specialists

View all Coronavirus

A new report highlights the severe impact the coronavirus pandemic and the subsequent lockdown has had on the NHS and people living with lung cancer. It states that the number of people urgently referred to a lung cancer specialist dropped by 75% during the first wave of the Covid-19 crisis.

It adds that the impact of Covid-19 “spans across the entire lung cancer care pathway”, including screening, diagnostics, treatment, palliative care and research, and estimates that there may be an additional 1,372 lung cancer deaths within five years of diagnosis due to the pandemic.

The report, Covid-19 Matters, was compiled by the UK Lung Cancer Coalition (UKLCC) from a meeting and interviews with 45 of the UK’s leading lung cancer clinicians and key patient groups, including Roy Castle Lung Cancer Foundation. The UKLCC brings together the country’s foremost lung cancer experts, senior NHS professionals, charities and healthcare companies.

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.”

According to NHS England, there were 62,461 two-week wait lung cancer referrals in 2019-20.

The report states that the reduction in referrals will lead to a backlog in outpatient appointments, surge in late-stage presentations and potentially hundreds of additional lung cancer deaths – reversing the progress achieved in lung cancer survival over the last 10 to 15 years.Between 2005 and 2015, five-year lung cancer survival almost doubled in England from 9 per cent to 16 per cent.

Our response – the Still Here campaign

The confusion caused arising from this guidance may have deterred many people from seeing their GP over signs or symptoms they were concerned about, which is why we launched the Still Here campaign.

The campaign aims to make people aware of signs and symptoms of the disease, and to remind them that, despite the impact of the pandemic, the NHS is still open and ready to help anyone worried that they may have lung cancer. 

Paula Chadwick, our chief executive, said:

All cancers have felt the devastation of the pandemic, but lung cancer faces an additional obstacle given that one of its most common symptoms – a persistent cough – is so often linked to Covid-19. For months, people with a cough followed the government’s ‘stay at home’ message.  

While this was essential to stop the spread of coronavirus, now it’s vital people feel able to go to their doctor if the cough persists, or if it’s accompanied by other common lung cancer symptoms, such as breathlessness, unexplained tiredness, coughing up blood or weight loss. They should go even if they live in an area currently in local lockdown or under the restrictions of the three-tier system.”

Martin Grange, who is both chair of the UKLCC and a trustee of our charity, adds:

“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.”

In the report, Lorraine Dallas, our director of information, prevention and support, points out that at the same time there was also a “sharp increase in late stage diagnosis”.  She added that ‘’there are now concerns that the progress seen in survival rates in recent years is at risk of being rolled back’’.

While pulling no punches in outlining the full extent of the impact of the virus, the report also suggests there are now opportunities for long-term improvements in lung cancer care in the UK:

‘’Covid-19 has clearly affected every aspect of our lives and our health care systems, so to that extent lung cancer is just one amongst many issues to be faced as a result. This report tries to identify not only the adverse impact of the pandemic on lung cancer care and outcomes, but changes in practice from which we can learn and potentially adopt and adapt to improve care in the future’’.

‘’We have no doubt that the survival and quality of life of lung cancer patients will have been seriously and adversely affected by changes in how cancer care has been delivered as a result of Covid-19. But we also know that there was much room for improvement before the pandemic began.

‘We would urge all those in whose hands the quality of care of lung cancer patients rests, be it clinicians, managers or policy makers, to reflect on the issues and actions outlined in this report and do all they can to ensure that we recover the momentum that had been building in the lung cancer community and work towards not a ‘New Normal’ but a ‘New Super-normal’ for the lung cancer patients who look to us for their care.

Key Findings and recommendations

Other key findings from the report include:

– It is estimated that at least one third of lung cancer patients have already died since the beginning of the pandemic – some deaths may have been labelled as Covid-19

– 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 per cent

– Over half (55%) of lung cancer nurse specialist nurses or their team member were re-deployed or unable to work as a result of Covid-19

As a result, the report makes 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.

– 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.

You can read or download the full report here.