National Lung Cancer Audit

State of the Nation Report 2023

The National Lung Cancer Audit is a way of collecting and comparing how lung cancer is diagnosed and treated. The NLCA covers England and Wales with separate audits covering the other UK nations and territories. Since February 2022 the Clinical Effectiveness Unit of the Royal College of Surgeons in England has been responsible for this, along with other health care audits.

The most recent report “State of the Nation 2023” was published on 12 April 2023. The report includes information on lung cancer treatments for people in England diagnosed in 2021 and people in Wales diagnosed in 2020 – 2021. In England and Wales the number of people being diagnosed has increased to pre-pandemic levels.

Key Findings

The Report has detailed information on both England and Wales. Some of the overall findings are:

• The number of patients diagnosed in England in 2021 has returned to pre-pandemic levels with 34,478 patients diagnosed with lung cancer compared to 31,371 in 2020 and 33,091 in 2019.
• The proportion of patients with stage 1/2 PS 02 NSCLC undergoing curative-intent treatment in England has increased from 73% in 2020 to 79% in 2021.
• The proportion of patients with NSCLC stage 3b/4 and PS 01 receiving systemic anti-cancer therapy in England has increased from 55% in 2020 to 61% in 2021.
• The Covid19 pandemic in 2020 had an impact on the number of patients diagnosed in Wales which fell from 2,240 in 2019 to 2,067 in 2020 with a subsequent recovery in 2021 to 2,244.

The latest report includes a number of important results:

• 17% of patients who had non-small cell lung cancer had surgical treatment, an improvement from 15% in 2020. The surgical rate has not yet reached its pre-pandemic level of 20%
• 79% of patients with NSCLC (stage 1/2, PS 0-2) received treatment with curative intent. This has risen by 4% from 2020 but did not meet the audit standard of 80%
• 60% of patients with NSCLC (stage 3a, PS 0-2) received treatment with curative intent
• 70% of people who have small cell lung cancer had treatment with chemotherapy
• One year survival rose to 45% from 41% in 2019 in England but in Wales was at 39% for patients diagnosed in the first 6 months of 2021, a decline from the 2 previous years
• 93% of patients in Wales were assessed by at Specialist Nurse at the time of diagnosis

There is progress being made to recover services to pre-pandemic levels. The recommendations of the National Lung Cancer Optimum pathway are encouraging more rapid diagnosis and access to treatment. The expansion of  the Lung Health Check programme and roll out of UK Screening Committee recommendations may lead to diagnosis of lung cancer at an earlier stage in years to come. We are aware of the ongoing pressures on the NHS and the policy decision to integrate cancer into the long term plan rather than committing to a new Cancer Plan.

Full versions of the reports are available here:

The audit team is currently working on improving the involvement of people affected by lung cancer in its work. Updates and opportunities will be available in our news feed in the coming months.