GPs urged to be more alert in diagnosing lung cancer in non-smokers

Charities launch campaign to prompt family doctors not to neglect UK’s eighth deadliest cancer

Cancer charities are urging GPs to save lives by getting better at spotting the symptoms of one of Britain’s most lethal forms of the disease – lung cancer in non-smokers.

Macmillan Cancer Support and Cancer Research UK are among the groups to back a new campaign that launches this week intended to prompt family doctors to consider lung cancer as a likely diagnosis even in people who have never smoked.

The disease is closely linked to smoking, but around 6,000 non-smokers a year die of it, more than the death toll of 5,300 from cervical cancer, 4,500 from leukaemia and 4,200 from ovarian cancer. It is the UK’s eighth biggest cancer killer and the seventh commonest cause of cancer death worldwide.

Sufferers often visit their GP several times before being referred to hospital and diagnosed, by which time most are too late to undergo treatment that may cure them. Doctors are puzzled by why those who do not use cigarettes contract the “smokers’ disease”. They believe genetic factors and growing up in a household where one or both parents smoke are among the reasons.

“Lung cancer in never-smokers can be challenging to diagnose, but the incidence of lung cancer in people who have never smoked is increasing and the fact that so many are diagnosed with late-stage disease suggest that it is under-recognised by GPs”, said Jenny Abbott, the chair of EGFR Positive UK, one of the three lung-cancer charities behind the campaign. ALK Positive UK and the Ruth Strauss Foundation – set up by the former England cricket captain Andrew Strauss after his wife died of non-smoking related lung cancer in 2018 – are also involved.

“I was diagnosed with advanced stage lung cancer in 2018 and my diagnosis was a terrible shock,” Abbott said. “As a never-smoker I did not think I could get lung cancer.”

The campaign is using portraits of nine patients by the photographer Rankin, all of whom were found to be incurable, and eight of whom are non-smokers. One of them – Faye, an NHS student midwife who has never smoked – was 28 when she was diagnosed. Her disease was detected in A&E almost five months after she began to have symptoms.

Many non-smokers with lung cancer miss out on potentially life-saving treatment because, despite visiting their GP several times with symptoms such as a persistent cough, breathlessness or recurrent chest infections, they are not referred for an X-ray or scan.

Dr Jodie Moffatt, Cancer Research UK’s head of early diagnosis, said: “Lung cancer can be difficult to spot so it’s important that GPs are alert to their patients experiencing chest-related symptoms, and are making full use of tests to work out who might need further investigation.”

The charity is funding a research study to explore whether diagnosing the disease may be different in non-smokers to smokers.

Advertisements featuring the nine patients will run in specialist media for GPs, such as GP Online and the British Journal of General Practice, and on Facebook and LinkedIn.

Dr Alison Cook, the British Lung Foundation’s director of external affairs, said: “A lot of people don’t realise that it’s not just smokers who get cancer in their lungs. In fact one in six people dying of lung cancer are not smokers. It’s crucial that a more streamlined, faster process is put in place for diagnosing lung disease.”

Prof Martin Marshall, the chair of the Royal College of GPs, said family doctors were good at diagnosing cancer, but added: “Lung cancer can be a difficult cancer to identify in primary care, particularly if patients aren’t smokers, one of the well-recognise red flag for the disease.

“The symptoms, principally a prolonged cough, can be signs of other more common, less serious, conditions. This puts GPs in a difficult position as to whether to refer patients, because it would not be appropriate to urgently refer every patient who presents with a cough for specialist assessment.

“GPs need better access to diagnostic tests in the community and training to use them appropriately and in a timely way and interpret the results so that our decision to refer can be as informed as it possibly can be”.


Denis Campbell Health policy editor

The GuardianTramp

Related Content

Article image
NHS cancer guide for GPs and patients could save 5,000 lives a year, says Nice
Guidance on symptoms and tests drawn up by the National Institute for Health and Care Excellence for doctors and patients could transform cancer care in UK

Sarah Boseley Health editor

22, Jun, 2015 @11:29 PM

Article image
Lung cancer blood test for smokers goes on trial

Tests will be carried out on 10,000 patients identified as having a higher risk of developing disease

Barry Neild

23, Mar, 2012 @1:49 AM

Article image
Doctors should order more blood cancer tests, MPs say
TV presenter Simon Thomas, whose wife died from a rare form of blood cancer last year, is calling for better training of GPs

Nadia Khomami

17, Jan, 2018 @5:10 PM

Article image
Late diagnosis of lung cancer hitting survival rate, study says
Staff shortages in NHS cancer services and heavy workloads exacerbating problem

Denis Campbell Health policy editor

31, Jan, 2020 @12:01 AM

Article image
NHS lung cancer trucks boost early diagnoses in deprived areas of England
Mobile on-the-spot screening initiative begun in 2018 hailed as having ‘turned a huge corner’

Denis Campbell Health policy editor

23, Apr, 2023 @11:01 PM

Article image
NHS urges people to attend vital lung cancer check-ups in England
Mobile trucks target areas with highest death rates in effort to reach those living with undiagnosed disease

Andrew Gregory Health editor

18, Apr, 2022 @11:01 PM

Article image
Treatment delays leave UK facing cancer emergency, doctors warn
Clinicians warn of the UK’s ‘biggest cancer crisis ever’ as record-breaking treatment waiting times have become normalised

Andrew Gregory Health editor

14, Dec, 2022 @11:30 PM

Article image
Nearly 2m people may have undiagnosed killer disease
Public Health England is urging anyone with persistent cough or unusual breathlessness to see their GP in case they have lung or heart disease

Haroon Siddique

13, Jul, 2016 @11:01 PM

Article image
‘Revolutionary’ lung cancer drug made available on NHS in England
Patients in England first to benefit from Sotorasib after drug proven to halt growth of tumours for seven months

Andrew Gregory Health editor

10, Sep, 2021 @5:00 AM

Article image
Capita’s cancer screening blunder hits 50,000 NHS patients
NHS contractor’s failure to send out cervical cancer test results condemned as ‘gross incompetence’

Haroon Siddique

14, Nov, 2018 @2:55 PM