13th May 2019

Our response to the National Lung Cancer Audit Annual Report 2018

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This week saw the publication of the National Lung Cancer Audit Annual Report 2018 from the Royal College of Physicians (RCPs).

The report aims to disseminate results on the quality of care for people diagnosed with lung cancer in the period between 1 January and 31 December 2017.

Executive summary

  • For the first time, we report the proportion of patients with stage I/II disease and performance status (PS) 0–1 who have pathological confirmation of cancer – the result of 89% only just misses the audit standard of 90%.
  • 30% of patients are missing out on access to all the benefits of specialist nursing support.
  • Systemic anti-cancer treatment rates in patients with NSCLC and advanced/good PS increased from 62% to 65%; this is the first time that our audit standard of 65% has been met.
  • Chemotherapy rates in SCLC increased from 68% to 71%, exceeding our audit standard of 70%.
  • Surgery rates in NSCLC increased from 17.5% to 18.4%.
  • The curative treatment rate in early stage/good PS patients is relatively high at 81%, but we believe there is scope for this to be increased.
  • One-year survival rates (37%) are unchanged.

Paula Chadwick, chief executive to Roy Castle Lung Cancer Foundation, shares her thoughts on the latest figures:

“It is very encouraging to see that more people are able to have surgery and that more people with both non-small cell lung cancer and small cell lung cancer are receiving anti-cancer treatment.

We know that if lung cancer is caught early enough, curative treatment is possible and share the NCLA’s belief that there is scope to increase this beyond the 81% it is currently for early stage patients with a good performance status.

We believe the implementation of targeted lung health checks will not only play a significant role in achieving this, but also increase the number of people getting diagnosed early enough to have curative treatment options.

Where our concerns lie is the number of people who are missing out of access to a lung cancer nurse specialist.

Paula Chadwick, CEO of Roy Castle Lung Cancer Foundation

Lung cancer nurse specialists play a pivotal role in ensure the quality of care a patient receives. Studies have even shown that people with lung cancer live longer and cope better with treatment when cared for by specialist nurses. They also have a lower risk of being admitted to hospital unnecessarily.

Kay's husband, Alan, did not have the benefit of a lung cancer nurse specialist
Kay’s husband, Alan, did not have the benefit of a lung cancer nurse specialist

One of our supporters, Kay Wiseman, recently shared the story of her late husband, Alan. When describing the impact Alan’s death had on her, she said:

“Heartbroken doesn’t even begin to describe how I felt and still feel. For me, it wasn’t just losing Alan but it was the manner in which he died which haunts me.”

Alan didn’t have a lung cancer nurse specialist which meant he and Kay received very little communication about his condition or treatment and, as a result, Kay feels Alan wasn’t adequately cared for. This knowledge has made her loss even harder to bear.

This latest report shows Alan and Kay are sadly far from alone. Almost a third of people are not benefiting from having a lung cancer nurse specialist, and this is before the implementation of lung health checks which will only increase the number of patients and put further pressure on this essential resource.

Workforce in the NHS is a huge issue and needs immediate attention. The government must recognise this ticking timebomb and take urgent steps to address and resolve this crisis if it is to meet the aims and objectives set out in NHS England’s long-term plan and ensure everyone receives the highest quality of care they deserve.”