One in four lung cancers diagnosed at emergency departments

One in four lung cancer cases are being diagnosed via emergency presentation, according to new research commissioned by the Irish Cancer Society.

In addition, at least 62 per cent of all lung cancers present at a late stage.

Overall, 15 per cent or three in every 20 cancers during 2010-2014 were diagnosed were via emergency presentation.

The research also showed that patients from the most deprived populations were 54 per cent more likely to present as an emergency presentation across the top 10 major cancers, compared with the least deprived populations.

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For lung cancer specifically, patients from the most deprived populations were 41 per cent more likely to present as emergencies.

Emergency presentation with cancer is generally associated with more advanced stage, fewer treatment options and poorer survival outcomes.

Irish Cancer Society head of services and advocacy Donal Buggy said the preliminary research is immensely important as it is the first time in Ireland they have been able to see the proportion of cancers being diagnosed by emergency presentation.

“We already knew that two out of three lung cancers are diagnosed at a late stage, and now this research shows that one in four lung cancers - that’s over 600 cases of lung cancer a year - are being diagnosed in the emergency department,” he said.

“Out of those cases, unfortunately, in the majority, the patient’s lung cancer is already at stage three or four. Late diagnosis limits your treatment options and reduces your chances of survival,” he said.

Mr Buggy said lung cancer is the leading cause of cancer deaths in Ireland, with, on average, 1,855 people dying from lung cancer each year during 2012-2014.

“Late diagnosis is a significant contributory factor to this. Alarmingly, female lung cancer cases are projected to increase by at least 77 per cent between 2010 and 2040 and male cases by at least 52 per cent,” he said.

“In order to reduce lung cancer mortality in Ireland now, and into the future, we need to take urgent action to reduce the number of cancer patients diagnosed in the emergency department and at a late stage.”

Mr Buggy said there are a number of specific targets aimed at increasing the proportion of lung cancers diagnosed early in the National Cancer Strategy 2017-2026.

“We want the Government, the National Cancer Control Programme (NCCP), and organisations like the Irish Cancer Society, to come together to take urgent action and implement concrete measures that will improve the earlier diagnosis of lung, and other cancers in Ireland, during the lifetime of the strategy.”

“In many cases the signs and symptoms of lung cancer just aren’t known and recognised by the general population.

“Early symptoms of lung cancer are primarily a cough, a persistent cough, change in cough. Losing weight, losing appetite, should go see your GP about.”

He said up-front investment in the National Cancer Strategy is required in the HSE’s 2018 Services Plan, accompanied by strong actions on the number of people being assessed at Rapid Access Clinics within 10 working days, “to achieve targets which are not currently being met.”

“Benefit of smoking cessation we only see that coming through 20 - 30 years later, so we’re currently seeing the lung cancer incidence rates in men falling which is related to smoking rates in men falling in the 1980s, but over the next 20 years we’re going to see an overall increase in lung cancer cases in men and in women,” he said.

The Irish Cancer Society announced the initial research findings to coincide with their Annual Charles Cully Memorial Lecture and Medal Award 2017, taking place on Wednesday, which this year is focusing on the late diagnosis of lung cancer, and measures to improve earlier diagnosis.