Letter to the new Secretary of State for Health and Social Care regarding lung cancer screening
The Rt Hon Dr Thérèse Coffey MP
Deputy Prime Minister and Secretary of State for Health and Social Care
Department of Health and Social Care
39 Victoria Street
London SW1H 0EU
Dear Secretary of State
RE UK Lung Cancer Screening
As members of the UK Lung Cancer Coalition (UKLCC) we would like to welcome you to your new role as Secretary of State for Health and Social Care.
We are writing to you regarding the urgent need for a national screening programme for lung cancer. This matter is presently under consideration by the UK National Screening Committee, and we anticipate that they will issue a recommendation imminently. We hope that their advice will be positive, in which case we would like to ask you to take steps as quickly as possible to introduce national lung cancer screening throughout England.
Lung cancer is the UK’s biggest cancer killer (responsible for 21% of all cancer deaths with 34,771 deaths per year). The UK has among the worst survival outcomes in Europe and among other comparable countries. Around one-third of lung cancers are diagnosed via emergency admission to hospital and one and a half times more women die of lung cancer than breast cancer.
Lung cancer is a rapidly fatal disease and early diagnosis is vital. Pilot lung health check centres have already detected over 1000 cases of lung cancer of which 77% were early stage, curable cases. Therefore, we strongly believe that the implementation and roll-out of a screening programme will do more to improve lung cancer survival than any other single intervention. It will also be a major step to achieve the NHS target to diagnose 75% of all cancer at stage I or II.
If approved, it is essential that a lung cancer screening programme is backed up by a robust, accurate, standardised reporting system with a national multi-disciplinary steering committee to oversee the programme. While there should be uniformity in many aspects of the service, which requires well-planned quality assurance. There will need to be some tailoring according to local population and service needs. This will help to ensure that there is equal access and opportunity for those people in the more deprived socioeconomic groups where lung cancer is more common - as well as those in rural areas.
Indeed, recruitment of high-risk individuals is key to a successful programme. Research indicates that lung cancer screening could be an important driver for reducing health inequalities. In addition, there is evidence from the two largest (US) screening trials that women may benefit more than men from lung cancer screening. UK wide lung cancer screening also provides a tremendous opportunity for research and data collection.
One of the biggest challenges to a national screening programme will lie around workforce - to deliver the programme and meet the demand of performing and reporting extra CT scans. This is a critically important issue underpinning deployment of a successful screening programme. A recent Health and Social Care report estimated that on an FTE basis, the NHS is short of nearly 1,939 radiologists. However, a high-quality programme also requires considerable commitment from other clinical staff, notably respiratory physicians and those responsible for treatment with curative intent. In addition, admin staff at all levels are required for running and managing the programme.
The success of a lung cancer screening programme will be further extended by combining it with other public health initiatives, such as smoking cessation. However, while smoking is a major risk factor, we need to acknowledge other risk factors and recognise the growing number of people who develop lung cancer where it has not resulted from smoking, many of whom have late-stage cancer. We acknowledge your recent tragic loss of your parliamentary colleague to lung cancer – James Brokenshire.
The UKLCC is the largest multi-interest group in lung cancer in the UK – and comprises leading lung cancer clinicians, lung cancer nurses, charities, and health professional groups with an interest in fighting lung cancer and improving outcomes.
The UKLCC was established in 2005 with the ten-year ambition of doubling lung cancer survival across the UK (which was effectively achieved in England by 2015). Since then, the focus has been a re-doubling of five-year lung cancer survival to 25 percent and finding a route back to providing optimal lung cancer care following the pandemic.
We hope to hear a positive outcome from Government imminently as implementation of lung cancer screening in the UK is long overdue.
We would welcome the earliest opportunity to discuss a national lung cancer screening programme with you and your department colleagues. Please note: this letter will be uploaded to the UKLCC’s website.
UK Lung Cancer Coalition
- Clinical Lead: Professor Robert Rintoul Professor of Thoracic Oncology, University of Cambridge; Honorary Consultant Respiratory Physician, Royal Papworth Hospital NHS Foundation Trust; Lead Clinician for Cancer, Royal Papworth Hospital; Director, Papworth Trials Unit Collaboration
- Chair: Mr Martin Grange, Patient representative, member of the Lung Cancer Screening Advisory Group
- Professor David Baldwin Honorary Professor of Respiratory Medicine; Consultant Respiratory Physician, University of Nottingham
- Dr David Feuer, Consultant in Palliative Medicine, Barts and The London NHS Trust
- Professor John Field, Roy Castle Lung Cancer Research Programme, The University of Liverpool
- Professor Michael Lind, Professor of Medical Oncology, University of Hull
- Dr Nick Screaton, Consultant Thoracic Radiologist, Royal Papworth Hospital NHS Foundation Trust
- Dr Nicholas Woznitza, Consultant Radiographer and Clinical Academic, Homerton University Hospital Foundation Trust
- Miss Juliet King, Consultant Thoracic Surgeon
- Dr Steve Holmes, General Practitioner, The Park Medical Practice, Shepton Mallet, Somerset
- Nasar Turabi, Director of Evidence and Implementation, Cancer Research UK
- Professor Kevin Blyth Professor of Respiratory Medicine, University of Glasgow; Honorary Consultant Respiratory Physician, Queen Elizabeth University Hospital, Glasgow
- Professor Keith Kerr Consultant Pathologist
- Dr Wendy Anderson Consultant Respiratory Physician, Antrim; Northern Ireland Lung Cancer Co-Lead
- Primary Care Respiratory Society
- Roy Castle Lung Cancer Foundation
- Yorkshire Cancer Research
- EGFR Positive
- ALK Positive UK
- Roche UK
- AstraZeneca UK