BTS recommendations to respiratory physicians for organising the care of patients with lung cancer

Lung cancer is the commonest cancer in the UK with about 35 000 new cases per year.1 More than 100 patients will present annually to an average district general hospital serving a population of 250 000 and about five to each general practice partnership looking after 10 000 patients.2 Although the overall prognosis is poor, with a mean survival in the UK of less than six months,3 rapid diagnosis and assessment are important to determine operability, suitability for radiotherapy, chemotherapy, or palliative interventions, and to minimise the anxieties of patients and their families.

The British Thoracic Society (BTS) recognises that it is of paramount importance to ensure that all patients with a working diagnosis of lung cancer have access to first class care. These recommendations have been produced because the BTS believes that they will represent an important contribution to the delivery of better patient care and will be an essential contribution to other UK national initiatives.

There are four additional reasons for the production of these recommendations.

(1) As a result of the publication of the Calman-Hine Committee report4 the organisation of cancer services in England and Wales is undergoing a fundamental review and a subsequent document from the Department of Health has given support to “the development of specific multidisciplinary teams in the treatment of lung cancer”.5

(2) Three sets of recommendations comprising technical recommendations for lung cancer management and based on literature reviews have recently been published,2 6 7 and there is a need for physicians to attempt to implement them.

(3) There are presently ongoing initiatives from Regional Cancer Service Review Groups, the Clinical Outcome Group (subgroup on cancer guidance for purchasers), and from the Research Unit of the Royal College of Physicians concerning the organisation and audit of lung cancer services to …