Background Survival rates from lung cancer are poor in England with 5 year survival of 8% of men and 9% of women.1 We hypothesised that greater awareness of lung cancer symptoms resulting from local (2011) and national (2012) campaigns had increased our 2 week wait (2 WW) referrals and may have led to earlier diagnosis and better survival rates.
Methods We carried out a retrospective analysis of data between 2008 and 2013 of all patients referred with a new diagnosis of lung cancer. For all new referrals; the number of 2 week GP referrals, patient demographics, treatment modality, survival, and time to first outpatient appointment were examined.
Results 2 WW referrals increased by 26% from 108 in 2008 to 421 in 2013, (peak 447 in 2012) and the number of confirmed lung cancer cases was 236 and 272 respectively, with 253 in 2012. 29.8% of patients presented as an emergency in 2013 compared to 39.4% in 2008. During 2008 and 2010 4.2(mean)[0.75](SD)% patients presented with stage IA disease compared to 6.3[0.7]% during 2011 and 2013 (p = 0.05). The rate of presentation with stage IV disease did not change significantly (50% vs56.6%, 2008 and 2013 respectively). 15.1% cases underwent curative treatment (surgical) in 2013 compared with 10.1% in 2008. Survival at 6 and 12 months was unchanged. The time to first outpatient appointment was not significantly different (mean of 8 days).
Conclusion The peak of 2 WW referrals coincided with local and national awareness campaigns. Although there was an increase in 2 WW referrals this was not reflected in the number of confirmed lung cancer cases. However, there has been an increase in the percentage of Stage IA diagnoses and resection rates which may have been a result of the campaigns increasing awareness amongst physicians and leading to earlier referrals.
Office for National Statistics. Patients diagnosed 2005-2009 and followed up to 2010: Date accessed 12-07-2014. http://www.cancerresearchuk.org/cancer-info/cancerstats/types/lung/mortality/uk-lung-cancer-mortality-statistics