Lung Cancer: Calls for routine screening

18th February 2021 Clinical Negligence

The valuable findings of a large NHS study have been published this week, and they highlight the importance of early CT scans in the detection of lung cancer (The Guardian). 

The study, carried out by University College London Hospital NHS Trust, found that thousands of lives could be saved if patients were screened for the deadly disease before it becomes incurable, and as a result, experts in the field are now calling for the government to bring in routine scanning for all smokers and ex-smokers in order to reduce the huge death toll. 

Lung cancer is a particularly vicious form of cancer as it is notoriously difficult to detect.  Often, symptoms such as a long-standing cough and persistent breathlessness don’t present until the cancer is at an advanced stage, and as a result, three-quarters of patients only present to their doctor and receive a diagnosis when the cancer is already stage 3 or 4.  This often rules out lifesaving treatment and makes the disease much more difficult to control. 

In contrast, as part of the recent study, over 12,000 smokers and ex-smokers were invited for a “lung health MOT” which included a CT scan of their chest.  The team found 180 cases of otherwise undetected lung cancer, and importantly, 70 per cent of those were found to have stage 1 or 2 disease.   That is a vast improvement, and means the options for treatment for those patients are greatly enhanced.  In fact, it is estimated that a similar screening programme could lead to a 25% fall in the number of men dying of lung cancer and 30-40 per cent fewer deaths among women. 

Having investigated a number of delayed diagnosis claims in my clinical negligence practice, I know only too well the impact early treatment can have on disease progression and the prospects of survival.  At JMW, we often act for people whose cancer has unfortunately gone undiagnosed and their prognosis is much less favourable as a result.  I would therefore strongly support the call for CT scans to become routine in the detection of this awful disease. 

Of course, it does rely upon the CT scans being correctly interpreted.  Only this week, I settled a claim where lung cancer was missed on several scans and x-rays.  “Susan” was presenting with symptoms from 2012 onwards, and despite several scans to investigate her shoulder pain over the next couple of years, and a mass being visible, the tumour was missed.  Consequently, “Susan’s” disease was left to progress and she was only diagnosed at a very late stage in 2015.  There were no options for her to have curative treatment, and she sadly died two months later.  Had she been diagnosed in 2012, our evidence suggested that she probably would have had surgery to remove the tumour, and her life expectancy would have been improved.

Whilst routine scanning will rely on the correct interpretation of the images, this tragic case highlights the importance of early detection. 

In the UK, around 48,000 people a year are diagnosed with lung cancer, and 35,100 die from it.  That is 96 people a day.  Something needs to be done to try to bring those figures down, and I am pleased to see this study highlight the effectiveness of early CT scans.   We have targeted screening for the likes of breast, cervical and bowel cancer, so why not lung cancer, which kills more people in England than any other cancer? 

I hope the optimistic findings from this study will open the door for positive change, and the implementation of a lung cancer screening programme in order to save more lives. 

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Rebecca Cahill is an Associate Solicitor located in Manchesterin our Clinical Negligence department

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