Lung Cancer Pathway Dr Heather Harris - Consultant Radiologist Dr Mohamed Abdulla - Consultant Respiratory Medicine

Why we need to do better?

CRHFT data for stage at diagnosis

CRHFT 1 Year Survival vs National

Early diagnosis is the key

Who to refer to 2wk lung clinic patients over 40 years and have unexplained haemoptysis CXR Suspicious of Lung Cancer (Use NICE guidance to assess risk) If CXR is normal or not suggestive of Lung cancer, avoid using the 2wwk wait Lung cancer referral pathway   After CXR is not suggestive of cancer and If it is felt patient still needs to be seen by a chest physician, refer as urgent or routine depending on the need but NOT as 2wwk wait.

Imaging in the Lung Cancer Pathway

ICE screenshots for CXR

ICE screenshots for CXR

ICE screenshots for CXR

ICE screenshots for CXR

Chest Xray Risk stratification Request as URGENT CXR ‘suspicion for lung cancer’ Identified in imaging as ‘suspicion of lung cancer’ Xray & Report within 3 days of request If abnormal, report will be sent back as UER to GP and MDT coordinator Advice on report to inform patient, request CT and refer to lung 2ww clinic

CT Scan

ICE screenshot for lung cancer CT

CT scan Staging CT of Chest and Abdomen with contrast Aim - Scan done within 3 days of CT request Aim - Scan reported within 7 days of sending CXR report out Relies on prompt CT request from GP