National cancer plan: progress report - August 2022

Cancer Plan Progress Updates: A Focus on Lung Cancer

Data on Lung Cancer

As documented in the section on mortality data, lung cancer is the most common cause of death from cancer in Scotland (3,874 deaths in 2020). Nearly a quarter of all cancer deaths in 2020 were attributed to lung cancer; this is more than double that of colorectal cancer, the next most common cause of death from cancer.

Actions for Lung Cancer

Action 28 – Detect Cancer Early Programme

Commitment: Use the Detect Cancer Early (DCE) Programme to support an increase in the proportion of Scotland’s most common cancers (bowel, breast and lung) detected early. Invest an additional £500,000 in developing a lung cancer awareness campaign that will launch in 2021, with stakeholders supporting delivery through feeding in patient views.

Progress: The Detect Cancer Early (DCE) lung cancer campaign – entitled Settling In - launched on 31 May 2021 and ran for 5 weeks. Almost two-thirds (64%) of those who saw the campaign did something as a result. Urgent suspicion of lung referrals, and numbers being treated for lung cancer, have returned to pre-COVID-19 levels. The campaign re-ran in July 2022 and the impact of the campaign will again be monitored through independent post-campaign evaluation with the target audience – those aged 40+ from areas of deprivation.

Detect Cancer Early Staging Data for 2019 and 2020 have been published by Public Health Scotland. These data show changes in the number of patients diagnosed with Scotland’s most common cancers over time. DCE staging data covering 2020 and 2021 are expected by Autumn 2022, which will enable a broader assessment of progress. Meanwhile, as committed to in the NHS Recovery Plan, work is underway to develop a new earlier diagnosis vision for Scotland, which will form part of the new cancer strategy due to publish in Spring 2023.

Action 29 – Review of urgent suspicion of lung cancer referrals

Commitment: We will keep clinical guidance on the management of urgent suspicion of lung cancer referrals under review, and develop additional primary care guidance if required, with support from the Scottish Primary Cancer Care Group.

Progress: Following discussion with the Scottish Primary Cancer Care Group, this guidance has now been archived (19 April 2022) and we have reverted back to the existing Scottish Referral Guidelines for Suspected Lung Cancer.

Action 30 – Research into the feasibility of lung health checks

Commitment: We will appraise the options, opportunities, harms and benefits of targeted lung health checks in Scotland through exploratory research carried out by the University of Edinburgh.

Progress: The research is being carried out by the University of Edinburgh and was subject to initial delays due to the pandemic. However, the research team is now recruiting and scanning participants within NHS Lothian, targeting those from areas of deprivation, at higher risk of lung cancer. The current phase of the study ends in September 2022 with work underway to determine next steps for the project.

Action 31 – Monitor the impact and effectiveness of one-stop lung clinics

Commitment: We will monitor the impact and effectiveness of one-stop lung clinics to ensure best practice is rolled out across the country.

Progress: This action has since been superseded by the development of the first national optimal diagnostic cancer pathway, as reflected in NHS Recovery Plan. The pathway aims to achieve faster and earlier diagnosis with improved patient experience.

Scotland’s optimal lung cancer pathway has been developed in close collaboration with regional clinical leads for lung cancer in NHS Scotland, with learning gleaned from NHS England. There has been engagement on the proposed pathway and implementation challenges through regional Managed Clinical Networks (MCNs) and a national engagement event in March this year. The pathway is expected to be published later in 2022.