The BMJ Awards 2020: Cancer care team of the yearBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m843 (Published 12 March 2020) Cite this as: BMJ 2020;368:m843
- Jacqui Wise, freelance journalist
- London, UK
Lung cancer emergency pathway
Many patients with lung cancer present with severe symptoms requiring emergency admission to hospital without ever having seen a lung cancer specialist.
One of the delays in the traditional lung cancer pathway often results in patients waiting weeks between an abnormal chest radiograph arranged by their general practitioner triggering a computed tomography (CT) scan in the hospital, before a diagnosis of lung cancer can be made. To speed up this process and reduce emergency lung cancer presentations, University Hospitals of Leicester NHS Trust implemented a direct-to-CT pathway.
Under the new pathway, if a radiograph indicates possible lung cancer the hospital automatically arranges a CT scan within three days. A lung cancer specialist nurse meets with the patient at the time of the scan to obtain a brief history. The patient’s case is reviewed at a triage meeting led by a respiratory physician. If there are any concerns or the CT scan shows advanced cancer, patients are reviewed urgently in clinic the same day or admitted straight away.
The new pathway has resulted in patients being diagnosed with lung cancer earlier. Data from the first 11 months have shown a 25% reduction in the emergency presentation of lung cancer.
“Patients who are admitted via the emergency route do worse as they tend to be presenting at a very late stage,” says Muhammad Tufail, consultant respiratory physician. “By making specific changes to our pathway we have been able to diagnose lung cancer much earlier and prevent the emergency presentations of lung cancer for many patients.”
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