1. 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

2. 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

3. 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

4. Where are we?
Last 10 years lung cancer consistently UK biggest cancer killer
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

5. 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 %
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

6. 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!

7. 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

8. 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

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

10. Healthcare professional attitudes survey – A UK snapshot

11. 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

12. 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

13. 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