The number of patients being urgently referred to a lung cancer specialist in the UK dropped by 75% in the first wave of the COVID-19 pandemic. At least one third of those already diagnosed have died since the beginning of the pandemic.
These are the two key, but worrying, findings from the recent report published by the UK Lung Cancer Coalition (UKLCC), which has assessed the impact of COVID-19 on the lung cancer healthcare pathway and what they believe must be done to prevent further unnecessary death.
“Fear of engaging with health services, halting the national program of lung cancer screening pilots, and restricted access to diagnostic tests have all contributed to a drop in urgent 2-week wait GP referrals in England,” explains Mick Peake (University College London Hospitals, UK), outgoing chair of the UKLCC’s Clinical Advisory Group.
The UKLCC has been steadily working towards a 5-year lung cancer survival rate of 25% by 2025 for a number of years and have been pushing on a range of efforts to achieve this. The emergence of COVID-19 has had a huge impact on this goal and the group have since been working to understand the effects of the pandemic in detail to ensure deviation from this important goal is limited as much as possible.
Their report covers the impact of COVID-19 on the lung cancer healthcare pathway in the UK, challenges that have emerged from the endemic period, opportunities for innovation and the UKLCC recommendations for further action.
Between 2005– 2015, 5-year survival for lung cancer in the UK almost doubled to 16%; however, the report explains that the severe impact on healthcare has started to reverse this trend, with survival estimated at 15.4% in 2020. Later-stage presentations will only add to this worrying direction.
The key findings from the report include an estimated one third of lung cancer patients having already died since the pandemic (some deaths being labeled as COVID-19); a sharp increase in risk of death following lung cancer surgery from 2% to 40–50%; and more than half of UK lung cancer specialists have been redeployed or have been unable to work during the pandemic.
Government guidance to stay at home if you have a cough has been a major factor in reducing the number of those visiting healthcare practices for screening or referrals and the Clinical Advisory Group have made a number of key recommendations to offset this impact.
The first is to launch a ‘Be Clear on Lung Cancer and Covid-19’ campaign, as a matter of urgency, to increase awareness of lung cancer symptoms and the overlap with COVID-19 symptoms. Public confidence in engaging with healthcare services as early as possible should be a concerted focus.
Further to this, the group suggest that local pilot lung cancer screening programs must quickly be resumed to counter the impact of late-stage referrals that will be seen as the COVID-19 pandemic continues.
UKLCC and the Clinical Advisory Group includes a number of patient representatives and oncology nurses. A key contribution they have brought is to call on the Government to urgently review isolation and visiting restrictions in hospitals to enable critically ill patients to see their families during the final phase of their lives.
Lung cancer can be cured if diagnosed early enough and the impact of COVID-19 must be reduced. Martin Grange, chair of the UKLCC urges “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.”
Interested in this topic? Read more with Future Oncology’s top picks:
- Lung cancer: a brief review of epidemiology and screening
- A clinical dilemma amid COVID-19 pandemic: missed or encountered diagnosis of cancer?
- Perspectives of lung cancer control and molecular prevention
- Thoracic surgeon and patient focus groups on decision-making in early-stage lung cancer surgery
Source: United Kingdom Lung Cancer Coalition. 75 per cent drop in urgent lung cancer referrals during lockdown says experts. Press release: www.uklcc.org.uk/75-per-cent-drop-in-urgent-lung-cancer-referrals-during-lockdown-say-experts/