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Fri 24 Jun 2022

People from deprived areas of Wales face worse outcomes when it comes to lung cancer, says report

A new report published today by Tenovus Cancer Care has called for action to tackle inequalities and improve outcomes for people with lung cancer in Wales.  

In Wales, approximately 1,900 people a year die from lung cancer (Public Health Wales, 2022), making it the biggest cause of cancer death in the country.  

The report comes as the UK National Screening Committee considers making recommendations around the introduction of targeted screening for lung cancer, following a public consultation.  

Lung Health Checks (LHCs) are a targeted health intervention which includes low dose computed tomography (LDCT) screening for people aged 55 to 74 with a history of smoking. 

In Wales, 45 per cent of lung cancer cases aren’t diagnosed until Stage 4 (Public Health Wales, 2021), when treatment options are more limited.  

Late diagnosis has a significant impact on mortality. When lung cancer is diagnosed at Stage 1, there is an 85 per cent chance of survival, compared to just 15 per cent when identified at Stage 4 (Public Health Wales, 2022). 

The introduction of targeted LHCs is predicted to prevent more than 20 per cent of lung cancer deaths amongst those screened and improve outcomes for many more patients (Wales Cancer Network, 2020). 

However, the Tenovus Cancer Care report explains the importance of mitigating inequalities before rolling out cancer screening programmes.  

People who live in deprived areas of Wales are 2.75x more likely to develop lung cancer Public Health Wales, 2022.

Increased smoking rates, lower symptom awareness, barriers to seeking help and fewer treatment options due to likelihood of comorbidities are all inequalities recognised in the report which contribute to higher rates and worse outcomes for patients in deprived communities.  

Current screening programmes, including the Bowel Screening Programme, have seen low uptake amongst people from deprived socio-economic backgrounds. The report makes several recommendations for Welsh Government and NHS partners to consider to narrow the inequality gap and improve lung cancer incidence and survival.  

Despite the seriousness of a lung cancer diagnosis, it is not a death sentence. Everyone deserves the same chance of survival, and we want to make sure as many people as possible are picked up early, whatever their circumstances.    

The introduction of lung cancer screening – something Tenovus Cancer Care has repeatedly called for - will save hundreds of lives across the country. 

However, the report demonstrates a one-size-fits-all approach could do more damage in increasing the deprivation gap.  As we look towards a future where Lung Health Checks are made available in Wales, it’s vital to understand and address the causes of inequalities.

Judi Rhys MBE, Chief Executive at Tenovus Cancer Care

The evidence for targeted lung cancer screening has been growing for some time. Lung cancer is by far the biggest cancer killer in Wales, in no small part due to most cases being found at a late stage. Lung cancer is curable when found at an early stage, and screening allows us to find cancers earlier and save lives.”

There is a lot of work to do to develop a lung cancer screening programme in Wales, and hopefully a recommendation will help accelerate those plans.

Dr Sinan Eccles, Consultant Respiratory Physician at Royal Glamorgan Hospital

Late diagnosis, poor survival rates, links with deprivation and negativity around its association with tobacco, make this a disease of particular, and unmet, need.  

As such, this report is warmly welcomed. It provides context to the scale of the lung cancer public health problem in Wales and advocates for solutions, through prevention by ensuring properly resourced stop smoking services and through detection at early stage of the disease.

Dr Jesme Fox, Medical Director at Roy Castle Lung Cancer Foundation

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