CT Scanning Shortage 'Affects UK Lung Cancer Survival'

Tim Locke

January 30, 2020

DUBLIN — A cancer conference heard how lung cancer survival is affected by the UK ranking third from bottom of major European countries for CT scanners per million population.

Prof David Baldwin, consultant respiratory physician, Nottingham University Hospitals, was speaking about why the UK's lung cancer survival could be better, at the British Thoracic Oncology Group (BTOG) annual meeting in Dublin.

He said there was some good news, with a big reduction in lung cancer age-standardised incidence rates in men. "This is the biggest public health success, other than infectious diseases that's occurred," he said, mainly due to smoking cessation.

However, availability of CT scanning was a problem, with surveys indicating a shortage of radiologists, too few to run services safely, and large bills to cover staffing gaps: "£165 million pounds bill in 2018 alone just filling in the gaps and the amount spent on outsourcing being able to fund nearly 2000 full-time radiologists, which is more than the number of the 1100 shortfall. That's shocking."

He then showed a graph compiled from multiple sources looking at the number of CT scanners per million people and compared other countries with the UK. "France had double the number of scanners. Italy more than double. Germany three times the number and the US at five times the number of scanners.

"We are third from the bottom in European countries that have relatively wealthy economies, third from the bottom."

He continued: "So one of the reasons I say we have poorer outcomes is we don’t have availability of CT scanners."

Call to Action

He also talked about forthcoming national diagnostic and treatment pathways and logistics helping to shorten diagnostics processes.

"The front end of the pathway is where we have this very rapid progress from chest X-ray through to CT and the clinic. The rationale behind that was because we know that in large GP primary care data sets chest X-rays start about 6 months prior to diagnosis of lung cancer. And if we put in the new 28 day target which comes out in April of this year, then most of the patients don't meet that. But if we start the pathway, [at] the first chest X-ray, then we’re going to bring forward the diagnosis massively for a lot of the patients. So it’s really quite important."

He concluded his "call to action" saying the National Lung Cancer Pathway had to be fully implemented, "we need a full rollout of CT screening for lung cancer, more, and better, treatment".

"We need to commission equal enthusiasm, expertise, and teamwork. And that's a bit of a challenge across the whole of the UK, and we need to make sure you enhance the capacity at every opportunity with equipment, personnel, and the use of newer techniques, such as AI."

British Thoracic Oncology Group (BTOG);  18th Annual Conference 2020, Dublin, 29th to 31st January 2020.

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