Monday 04 February 2019 at 13:44

Much needed, but much still to do: Our response to NHS England’s announcement for lung health checks

NHS England has today confirmed a multimillion pound investment to roll out 14 targeted lung health checks across England to improve the early detection of lung cancer.

Building on its 10-year plan and its commitment to improve early detection and lung cancer survival rates, the checks will be available to people aged 55 to 74 who have a smoking history and live in one of the following areas:

Locations for NHS England's four-year targeted lung health checks
14 locations have been identified as part of NHS England's targeted lung health check pilot

Lung cancer remains the biggest cancer killer in the UK, killing more people than breast, prostate and pancreatic cancer combined. With vague symptoms, which often only start to show when the cancer is at an advanced stage, early detection is difficult and, as a result, survival rates lag behind.

The introduction of targeted lung health checks will help us get ahead of the disease and see more people diagnosed at an early stage when curative treatment is an option.

Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation, shares her thoughts on the announcement, and what’s next for the early detection of lung cancer:

“We welcome today’s announcement confirming the roll out of 14 lung health checks across England. Given our own first-hand knowledge of these programmes, coupled with the staggering results from the NELSON trial which saw a 26% reduction in mortality when high-risk patients had a CT scan, this is a big step forward in improving the early detection of lung cancer.

“I remember when we first met Bill Simpson, one of the people whose lung cancer was detected early through our lung health check in Nottingham. He said something that still echoes in my ears: “If I hadn’t had gone for that scan, I could have been dead in a years’ time.”

It’s a statement that still gives me goose bumps, the bluntness of it, and yet this has been the reality for lung cancer; people living unbeknown with the disease and the tumour growing, undetected, until there is nothing that can be done.

But now, with the roll out of targeted lung health checks at 14 sites across England, there are going to be more people like Bill. More people for whom something can be done, and it’s long overdue.

Funding into lung cancer has been considerably lower than that given to other cancers. As a result, survival rates lag significantly behind – currently only 10% of people diagnosed with lung cancer will survive for five years or more compared to 87% for breast cancer. It is because of this that lung cancer is the biggest UK cancer killer and so this level of investment is long-awaited and much needed, and I feel extremely proud, and slightly emotional, given our legacy in this accomplishment.

The pioneers of early detection

Early detection has been at our core since the charity first launched. In 1993, we awarded the first grant of its kind to Professor John Field to study generic changes in lung cancer and thus laying the groundwork for screening of high-risk individuals.

This work also formed the basis for the Liverpool Lung Project (LLP), a project we funded from 1996 which used epidemiological techniques to develop a risk model which could help identify individuals at high risk of developing lung cancer. The result of this work was used by Prof Field as he led the UK pilot study into the use of CT screening for identifying lung cancer.

The work of the LLP continued, and we funded the first UK mobile lab to recruit high risk people into the project. It almost feels like we’ve come full circle; that first mobile unit would not have been a million miles away from the mobile units that are going to be used in the roll out.

There is no doubt that this work – recognised as both ground breaking and unique – has played a substantial role in this sizeable investment.

There is still much more to do

There is no question, if implemented properly, targeted lung health checks will have a major impact on lung cancer survival rates - but we need to make sure that there is the capability and capacity to treat those diagnosed.

And whilst this a notable and needed step forward, it is not the full implementation we want and the ultimate aim for a UK wide lung cancer screening programme remains a top priority for us.

We also recognise neither the announced target lung health checks, nor a national screening programme will not benefit everyone and so this is by no means the end of the process. There is still much more to do.

Lung cancer is a disease which does not discriminate; it can affect anyone and so we need to continue to develop better screening tools for everyone including those will be excluded from targeted screening, such as never smokers.

The second part of the Liverpool Lung Project was aimed at identifying the early molecular changes which occur in lung cancer and in pre-cancerous lung cells and so identify biomarkers to be used in early detection.

This is exactly what our researchers continue to work on right now – from blood tests to sputum swabs, these biomarkers are the long-term future of early diagnosis in lung cancer and where our focus remains.

But this takes nothing away from today’s announcement. It is one to be welcomed. It is one to be celebrated. It is one that has been a long time coming and we look forward to what we know it can achieve.

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