Quality statement 1: Public awareness

Quality statement

People are made aware of the symptoms and signs of lung cancer through local coordinated public awareness campaigns that result in early presentation.

Quality measure

Structure: Evidence of local arrangements to ensure that people are made aware of the symptoms and signs of lung cancer through local coordinated public awareness campaigns that result in early presentation.

Process: Proportion of people newly diagnosed with lung cancer who were identified as a result of a local public awareness campaign.

Numerator – the number of people in the denominator who were identified as a result of a local public awareness campaign.

Denominator – the number of people newly diagnosed with lung cancer who presented with at least 1 symptom suggesting lung cancer.

Outcome:

a) People with a new diagnosis of lung cancer whose first contact with secondary care for their cancer is an emergency hospital visit or admission.

b) 3‑month and 1‑year survival rates from diagnosis.

c) Public awareness of symptoms and signs of lung cancer.

d) Stage at diagnosis.

What the quality statement means for each audience

Service providers ensure that services are in place to support people to be made aware of the symptoms and signs of lung cancer through local coordinated public awareness campaigns that result in early presentation.

Healthcare professionals support and participate in local coordinated public awareness campaigns to make people aware of the symptoms and signs of lung cancer and that result in early presentation.

Commissioners ensure they commission local coordinated public awareness campaigns to make people aware of the symptoms and signs of lung cancer and that result in early presentation.

People are made aware of the symptoms and signs of lung cancer through local public awareness information and activities, and see a healthcare professional if they experience symptoms of lung cancer.

Source guidance

Lung cancer: diagnosis and management (2019) NICE guideline NG122, recommendation 1.1.1

Data source

Structure: Local data collection.

Process: Local data collection.

Outcome:

a) Data fields necessary for the calculation of the number of lung cancer patients who were referred to a consultant following accident and emergency attendance are available in the National Cancer Outcomes and Services dataset, which is available from the National Cancer Intelligence Network.

National Cancer Intelligence Network work on 'routes to diagnosis' produces reports on the proportion of lung cancer cases whose first presentation to secondary care was via an emergency admission.

b) Health and Social Care Information Centre National Lung Cancer Data Audit collects data on the proportion of patients submitted to the audit surviving to 3 months and 1 year after diagnosis.

1‑year survival from lung cancer is also an improvement area within the NHS Outcomes Framework 2012/13 (1.4v).

c) Local data collection. The lung cancer awareness measure is available from Cancer Research UK.

d) Local data collection.

Definitions

Symptoms and signs suggesting lung cancer include the following:

  • haemoptysis (in particular persistent haemoptysis in smokers/ex‑smokers older than 40 years)

  • unexplained or persistent (that is, lasting more than 3 weeks):

    • cough

    • chest/shoulder pain

    • dyspnoea

    • weight loss

    • chest signs

    • hoarseness

    • finger clubbing

    • features suggesting metastasis from a lung cancer (for example, in brain, bone, liver or skin)

    • cervical/supraclavicular lymphadenopathy

  • signs of superior vena cava obstruction (swelling of the face/neck with fixed elevation of jugular venous pressure)

  • stridor.

Early presentation means a person presents to a healthcare professional soon after they recognise that they fulfil criteria for seeking help, normally within 2 weeks. For example, if they have had a persistent cough for 3 weeks or haemoptysis they should seek help from a healthcare professional within 2 weeks.