1. Earlier diagnosis of lung cancer
Dr Neal Navani MA MSc PhD FRCP
Consultant Respiratory Physician, UCLH
Co-clinical lead, NLCA
@LungConsultant

2. IASLC Stage grouping for TNM 8
Earlier stage improves survival;

3. Millimeters matter

4. Olesen et al BJC 2009

5. Diagnosing lung cancer at earlier stage -1
Engage with primary care
Promote Be Clear On Cancer campaign
CXR and CT capacity
Ironmonger BJC 2015

6. Diagnosing lung cancer at earlier stage -1
Promote Be Clear On Cancer campaign
May to Late August 2017

7. Diagnosing lung cancer at earlier stage -2
Open access / self-referral for CXR
Advertising campaign
Community education
55% increase in CXRs in 2011 vs previous years (Callister et al.)
Reduced emergency admissions
GP direct access to CT
Clinical risk assessment tools

8. Diagnosing lung cancer at earlier stage - 3
Dysplastic airway lesions
Severe dysplasia / CIS on airway biopsy or at resection margin
Autofluorescence bronchoscopy
Surveillance for progression to invasive carcinoma

9. Diagnosing lung cancer earlier
Follow available guidelines
Biopsy lymph nodes vs primary
Nodule clinics / BTS guideline
Fewer scans
National optimal lung cancer pathway

10. Diagnosing lung cancer earlier
Lung-BOOST: pts Stage I - IIIA
Navani et al Lancet Resp Med 2015

11. Diagnosing lung cancer earlier
Navani et al Lancet Resp Med 2015

13. Diagnosing lung cancer earlier
Co-morbidity management
Increase biopsy rate
Increase active treatment rates
Increase radical treatment rates
Reduce decline in PS

14. Summary

15. @LungConsultant n.navani@ucl.ac.uk
Acknowledgments
UCLH Lung cancer MDT
UCL Respiratory
NLCA team
Mat Callister, David Baldwin
@LungConsultant