Presentation on theme: "By Dr Varuna Paranahewa"— Presentation transcript:
1By Dr Varuna Paranahewa Respiratory MedicineThe Urgent ReferralBy Dr Varuna ParanahewaGP ST3
2Lung cancer (NICE CG121)39,000 new cases of lung cancer in the UK each year35,000 people die from the condition; more than for breast cancer and colorectal cancer combined5.5% of lung cancers are currently cured
3The importance of early diagnosis (1.1.1) public better informed of the symptoms and signs that are characteristic of lung cancerDrs aware of Indications for Urgent CXR & Urgent Referral
8Symptoms and signs indicating urgent chest X-ray Offer URGENT CXR (report in 5 days) to patients presenting with haemoptysis or chronic resp disease with change in symptomsor any of the following if unexplained or persistent ( >3 weeks):coughchest/shoulder paindyspnoeaweight losschest signshoarsenessfinger clubbingsigns suggesting metastases (for example, in brain, bone, liver or skin)cervical/supraclavicular lymphadenopathy.
9Signs and symptoms indicating urgent and immediate referral Offer urgent referral to Chest physician Or Admit if either of the following are present:signs of superior vena cava obstruction (swelling of the face and/or neck with fixed elevation of jugular venous pressure)stridor
10Offer Urgent 2 Week referral to Chest physician if: Persistent haemoptysis in a smoker or ex-smoker older than 40 years … (CXR in pipeline, but no need to wait for result)a CXR or CT scan suggests lung cancer (including pleural effusion and slowly resolving consolidation) orCXR is normal but there is a high suspicion of lung cancerA history of Asbestos exposure with recent onset of chest pain/breathlessness/ unexplained systemic symptoms, where the CXR suggests pleural effusion/pathology or lung pathology
11Groups that are not covered by NICE Adults with mesothelioma.Adults with lung metastases arising from primary cancers originating outside the lung.Children (younger than 18) with lung cancer.Adults with rare lung tumours (for example, pulmonary blastoma).Adults with benign lung tumours (for example, bronchial adenoma)