Introduction
Lung cancer is the 3rd most common cancer diagnosed in the UK, accounting for approximately 13% of all new cancer cases annually. It is the second most common cancer in both males and females. Incidence of lung cancer is strongly related to age, with over 4 in 10 (44%) of new cases of lung cancer diagnosed in people aged 75 and over. In North Tyneside, the prevalence of lung cancer is 177 per 100,000 people. Latest data suggests approximately 216 new cases are diagnosed each year in North Tyneside[ii].
Both modifiable and non-modifiable risk factors for lung cancer are well known. Smoking, exposure to radon gas, exposure to chemicals such as asbestos, silica or diesel engine exhaust fumes, air pollution, family history and age are all associated with an increased risk of lung cancer. In England, approximately 30% of lung cancer cases are diagnosed at an early stage (stage 1 & 2), with 70% of cases diagnosed at later stages (stage 3 & 4). As is the case with other cancers, early diagnosis results in better survival rates. 1 year survival rates for those diagnosed at Stage 1 are between 85-81%. In contrast, 1 year survival rates among individuals with stage 4 lung cancer at diagnosis is between 15-19%.
Until recently, there was no national screening programme for lung cancer. In December 2020, a Lung Cancer Case Finding pilot intervention was initiated in North Tyneside. Under this pilot scheme, people with a recorded history of COPD who were registered with GP practices in Wallsend and North Shields were invited for screening. Of 420 patients that accepted the offer of early screening, 18 cancers were found, of which 17 were in the early stages able to receive curative treatment.
In 2022, the UK National Screening Committee recommended that targeted lung cancer screening becomes available nationally[vii]. In 2023, the national Targeted Lung Health Check scheme was rolled out. Under this scheme, people aged 55 to 74 with a GP record including a history of smoking are invited for an initial assessment. During this assessment, a questionnaire is used to determine whether a person is at a high risk of lung cancer. If they are deemed to be at a high risk, they are offered a low dose CT scan of the lungs and smoking cessation advice where required.