The Ambition: Achieving 25% 5 Year Survival By 2025 Richard S Steyn Chair United Kingdom Lung Cancer Coalition (UKLCC) Consultant Thoracic Surgeon, Heart of England NHS Foundation Trust Honorary Associate Professor, University of Warwick

UKLCC The United Kingdom Lung Cancer Coalition (UKLCC) - the country’s largest multi-interest group in lung cancer – is a coalition of the UK’s leading lung cancer experts, senior NHS professionals, charities and healthcare companies aiming to: Raise political awareness of lung cancer Raise the general public’s awareness of lung cancer – and especially encourage earlier presentation and symptom recognition Empower patients to take an active part in their care Improve lung cancer services in the UK

Dr Wendy Anderson Dr Dean Fennell Dr Steve Holmes Prof Keith Kerr Dr Jason Lester Prof Michael Lind Ms Lavinia Magee Dr Clive Mulatero Mr Babu Naidu Prof Mick Peake Dr John Reynolds Dr Robert Rintoul Dr Michael Snee Mr Richard Steyn Ms Carol Stonham MBE Dr Andrew Wilcock Dr Ian Williamson British Lung Foundation Macmillan Cancer Support Roy Castle Lung Foundation Tenovus Cancer Care British Thoracic Society National Lung Cancer Forum for Nurses The Primary Care Society

Where are we? Last 10 years lung cancer consistently UK biggest cancer killer 2014 35900 deaths (more than breast and bowel combined) Lung cancer not prioritised compared to other cancers Quality of outcome varies highly UK long-term survival still lags behind other countries In Europe: Northern Ireland 19/26 England 26/29 Scotland 27/29 Wales 28/29

Poorest survival any cancer 25% cancer deaths 84.2% seen by CNS 5 year survival 1 year survival England 16% 35% Scotland 9.8% 31.5% Wales 6.6% 26.5% Northern Ireland 10.5% 34.8% England Health inequalities -> 9900 avoidable deaths/yr 57.6% active treatment 24,000/yr late stage diagnosis Lung CNS access 33.7-100% 93% discussed at MDT Anti-cancer treatment 32-83% Northern Ireland CNS access 60->40% 45% discovered via ED 50.9% late stage Wales Lung CNS < 90% 22% cancer deaths 28/29 in Europe Only 12% diagnosed stage 1 99.6% discussed at MDT Scotland Poorest survival any cancer 25% cancer deaths 84.2% seen by CNS 93.6% discussed at MDT

The 25 by 25 ambition UKLCC calling for a drastic improvement in care for those with lung cancer across the UK to raise 5 yr survival to 25% by 2025 Explore existing evidence Opinions of lung cancer community patients/carers (102) MDT members (148) GPs (1000) NHS under massive financial pressures and resource strain but unprecedented opportunities offered by new national structures, local and regional autonomy and a drive for whole person care Lung cancer should not be a death sentence!

5 Year Survival Achievable? - 50% patients and carers consider achieving 5 year survival to be achievable - 65% HCPs felt difficult to achieve - 15% HCPs felt completely unachievable

85% lung cancer caused by smoking HCPs – reduction in smoking rates the second most important factor after early diagnosis GPs – improved access to smoking cessation services would have the second biggest impact after public awareness campaigns Risk of mortality substantially reduced by stopping smoking Risk of recurrence substantially reduced by stopping smoking

Early Diagnosis? 52% HCPs national screening programme for lung cancer should be introduced

Healthcare professional attitudes survey – A UK snapshot

PHASE 1(2016-2018): Fundamental steps to meeting a new ambition Governments to prioritise improvements in lung cancer survival A focus on prevention to reduce cases of lung cancer across the UK Annual lung cancer awareness campaigns to encourage earlier diagnosis Investment in evidencebased local screening programmes Audit performance of referral services against guidelines Commitment to use of expert clinical groups to ensure optimisation of pathway Research funding to support improvements in rapid diagnosis Address local variation in treatment, informed by pilot data programmes MDTs, in coordination with patients, to design tailored diagnosis pathways Patients have access to specialists, including lung cancer clinical nurses, to manage care

PHASE 2: 2019-2022 Optimising improvements for better survival rates Creation of UK Lung Cancer Taskforce, with a focus on improving five-year survival Commitment to funding of smoking cessation services which meets local demand Establishment of screening programmes to engage high-risk groups in each UK nation Increase the number of lung cancers diagnosed at the earliest stage to 40% Pilot the use of redesigned lung cancer pathways across the UK Improve the quality of data collection, analysis and application to match the best in Europe

PHASE 3: 2023-2025 Securing the 25 by 25 ambition Establish a UK/EU public health working group, led by the UKLCC and EPHA Set an official standard for 60% of those in higher risk groups to be screened through national programmes Ensure that target waiting times across the UK are being met for more than 90% of patients Achieve a five-year survival rate that places the UK among the highest performing 15 countries in Europe