From diagnosis to treatment: Why we need to prioritise lung cancer in the UK

Lung cancer has become a leading cause of cancer death worldwide and in the UK alone, nearly 50,000 people are diagnosed with lung cancer each year.[1],[2] To put this into context, lung cancer causes more deaths in the UK than any other cancer – more than bladder, pancreatic, and melanoma skin cancers combined.[2],[3] So what needs to be prioritised to help turn the tide??

Focusing on early detection and treatment of non-small cell lung (NSCLC)

We must first act to prioritise the diagnosis and treatment of lung cancer to address persistent high rates of late-stage diagnoses, stark disparities in care, and unacceptable survival rates, particularly for advanced stage NSCLC.[4],[5] ?

The vast majority (80-85 percent) of lung cancers fall into the NSCLC category.[6] Unfortunately, NSCLC often progresses unnoticed until it has advanced and spread beyond the lungs – 30-40 percent of NSCLC patients present with metastatic disease at the time of diagnosis.[7] Among the most typical lung cancer symptoms are a chronic cough, feeling breathless or wheezy for no reason, chest or shoulder pain, and unexplained weight loss.[8]?

Our mission in lung cancer is urgent and crystal clear

As the founding member of the Lung Ambition Alliance, a global alliance of patient, scientific, medical, and industry organisations dedicated to transforming lung cancer outcomes for patients, AstraZeneca is firmly committed to driving meaningful change.[9] We have a bold ambition to one day eliminate cancer as a cause of death, and will achieve this by propelling scientific understanding, fostering innovation, and optimising lung cancer care pathways. This clarity fuels my purpose in my role as Head of Oncology Medical Affairs at AstraZeneca UK. It also inspires the team to urgently bring new treatments to patients who are desperately in need to transform survival rates and shape the future of lung cancer care for patients and the NHS.?

Usual care fails national guidelines and trails European and USA survival rates

While there has been great progress in recent years, the UK is still off-track in achieving best practice guidelines and targets set out by the National Optimal Lung Cancer Pathway (NOLCP).[10] These significant shortcomings have been highlighted by the National Lung Cancer Audit (NLCA) State of the Nation Report 2024 – which illustrates that the time from diagnosis to treatment has worsened – in England, the median time was 41 days, and no Cancer Alliance was compliant with the NOLCP.[11] Curative treatment rates remain well below targets, with only 59% of stage IIIA NSCLC patients offered treatments with curative intent – such as surgery, radiotherapy, or multimodal combination with chemotherapy.[11] Almost one-third (32 percent) of patients are still being diagnosed after presenting via emergency care, and there is marked geographical variation in these rates.[11]?

Survival rates for lung cancer in the UK are alarmingly lower than those in Europe and the USA, a stark indicator of the urgent need for action.[10] The estimated five-year survival (2016-20) is among the lowest in Europe at 21 percent.[10] Survival rates also vary significantly by NHS Cancer Alliance with a range of 15 to 29 percent.[10] It is abundantly clear there is lots more room for improvement and the time for change is now.?

Behind these statistics are real people facing months of unbearable anxiety waiting for a CT scan or a lung biopsy because our NHS is under pressure like never before, while those who have been diagnosed are waiting anxiously to begin treatment, which is key to boosting their chances of survival.[12],[13]?

The UK should be striving for world-leading cancer outcomes. All cancer patients, no matter where they live, deserve to receive the highest quality care. A unified approach across the UK lung cancer community is essential to achieve meaningful progress. By integrating best practices and guidelines from around the world and adapting them to our local needs, we can enhance the quality of care, reduce inequalities, and save more lives.?

A bold vision to revolutionise care?

At AstraZeneca, we are working hard to improve outcomes for patients with lung cancer through the detection and treatment of early-stage disease, while also pushing the boundaries of science to improve outcomes in resistant and advanced settings. By defining new therapeutic targets, investigating innovative approaches, and improving access to new therapies, we aim to match medicines to the patients who can benefit most.

Scientific innovation is a powerful contributor to the UK’s economic growth, and we welcome the UK Government’s leadership increasing funding for the National Institute for Health and Care Research (NIHR) which will help to improve the environment to deliver clinical trials for new cancer treatments. We also welcome the UK government’s move to start a public conversation about the future of the NHS in England to ensure that all cancer patients across the UK can access the care that they deserve. The rules by which medicines are assessed by the National Institute for Care and Excellence (NICE) also need to be reappraised as they disadvantage cancer medicines and consequently, patients are missing out on vital new treatments. Embracing the latest scientific breakthroughs and promoting equitable access to novel therapies will pave the way for a future where lung cancer is no longer a death sentence. Together, we can transform the landscape of lung cancer care and deliver life-saving improvements for all affected individuals.?

#LungCancer

#Oncology

#Innovation

GB-58753 Date of preparation: November 2024

References

[1] World Health Organisation. Lung Cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/lung-cancer. Last Accessed: November 2024.

[2] Cancer Research UK. Lung Cancer Statistics. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer#heading-Zero. Last accessed: November 2024.

[3] Cancer Research UK. bl. Available at: Cancer mortality for common cancers | Cancer Research UK. Last accessed: November 2024.

[4] National Lung Cancer Audit. NCLA Patient and Public Report 2024. Available at: https://www.lungcanceraudit.org.uk/reports-publications/nlca-patient-and-public-report-2024/. Last accessed: November 2024.

[5] Tzu-Hsuan Chen D, et al. Ethnic disparities in lung cancer incidence and differences in diagnostic characteristics: a population-based cohort study in England. The Lancet Regional Health. 2025;48:101124.

[6] Cancer Research UK. Types of Lung Cancer. Available at: https://www.cancerresearchuk.org/about-cancer/lung-cancer/stages-types-grades/types. Last accessed: November 2024.

[7] Tamura T, et al. Specific organ metastases and survival in metastatic non-small-cell lung cancer. Mol Clin Oncol. 2015;3(1):217-221.

[8] Macmillan Cancer Support. Signs and Symptoms of Lung Cancer. Available at: https://www.macmillan.org.uk/cancer-information-and-support/lung-cancer/signs-and-symptoms-of-lung-cancer. Last accessed: November 2024.

[9] The Lung Ambition Alliance. Establishing a Pathway to Biomarker Testing. Available at: https://www.lungambitionalliance.com/content/dam/open-digital/lungambitionalliance/en/pdf/LAA-AIM-Establishing-a-Pathway-to-Biomarker-Testing-Whitepaper.pdf. Last accessed: November 2024.

[10] Cancer Research UK. National Optimal Lung Cancer Pathway (NOLCP). Available at:

www.cancerresearchuk.org/sites/default/files/national-optimal-lung-cancer-pathway_v4_01jan2024.pdf. Last accessed: November 2024.

[11] National Lung Cancer Alliance. State if the Nation Report 2024. Available at: https://www.lungcanceraudit.org.uk/wp-content/uploads/2024/05/NLCA-State-of-the-Nation-2024_16.05.24_V2.0.pdf. Last accessed: November 2024.

[12] BMA. NHS backlog data analysis. Available at: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis/ Last accessed: November 2024.

[13] Denton E, Conron M. Improving outcomes in lung cancer: the value of the multidisciplinary health care team. J Multidiscip Healthc. 2016:30(9):137-44.