A new study from researchers at Brighton and Sussex Medical School (BSMS) reveals that patients living with certain long-term health conditions may face delays in being diagnosed with lung cancer. This is particularly concerning as lung cancer remains the leading cause of cancer-related deaths in the UK for both men and women, with high mortality rates largely due to late-stage diagnosis.

The research highlights how some chronic conditions, such as chronic obstructive pulmonary disease (COPD) and asthma, can obscure early symptoms of lung cancer, leading to delays in diagnosis. The study analysed GP health records and hospital data from 11,870 lung cancer patients in England, diagnosed between 1990 and 2019.

Key findings

Dr Imogen Rogers, who led the analysis, reported that patients with one or more conditions that could provide "alternative explanations" for lung cancer symptoms experienced significant delays in receiving a diagnosis. The study found:• Patients with one "alternative explanation" condition, such as COPD or asthma, were diagnosed with lung cancer 31 days later on average.• Patients with two or more such conditions experienced an even longer delay, averaging 74 days.• COPD was identified as the condition resulting in the longest delay to lung cancer diagnosis, with affected patients being diagnosed 59 days later than those without the condition.

The study also found that conditions placing "competing demands" on a GP's time, such as arthritis or diabetes, did not significantly impact the time to lung cancer diagnosis once factors like age, sex, and smoking history were considered.

Implications for clinical practice

The research team suggests that clinical guidelines should be updated to highlight the potential for conditions like COPD to mask early symptoms of lung cancer. By raising awareness of this issue, they hope to reduce diagnostic delays and improve outcomes for patients.

"This research underscores the need for heightened vigilance in patients with chronic respiratory conditions," said Dr Rogers. "Recognising that these conditions can mask the symptoms of lung cancer is crucial in ensuring timely diagnosis and treatment."

Call for action

The NHS in Sussex is already exploring ways to improve early cancer diagnosis, and this study could play a critical role in shaping future strategies. The findings emphasize the importance of comprehensive patient assessments and the need for healthcare professionals to consider the possibility of lung cancer even in patients with existing respiratory conditions.

This research could pave the way for new guidelines and training for GPs, ultimately aiming to save lives by catching lung cancer earlier, even in patients with complicating health conditions.

The study, funded by the NIHR Applied Research Collaboration in Kent, Surrey, and Sussex, and involving collaboration between BSMS and the University of Kent, was published in the British Journal of Cancer.

Read the research paper.