Lung cancer toll worsened by attitudes

Britain has one of the worst survival rates from lung cancer in the West. Jeremy Laurance, Health Editor, finds the reasons are medical pessimism and smokers' guilt.

Anti-smoking campaigns are adding to the suffering of smokers by making them delay seeking medical treatment out of embarrassment, according to a study.

Negative attitudes dominate the treatment of lung cancer in Britain which kills more people than any other cancer. Smokers feel guilty about having brought the problem on themselves, doctors feel there is no hope and there is little public interest in a disease that principally kills the old and the poor.

Launching a campaign to raise awareness of the disease by the Macmillan Cancer Relief charity, Dr Robert Milroy, consultant respiratory physician, said lung cancer was the most virulent of all cancers causing 100 deaths a day in Britain. Eight out of ten newly diagnosed sufferers, of which there are 40,000 a year, die within 12 months. Only one in ten survives five years.

Dr Milroy said the "clear impression" from international figures on lung cancer survival was that Britain came out near the bottom of the European league. Operation rates to remove the cancer were also among the lowest in Britain.

"If we could improve diagnosis we could improve surgery rates and extend survival. There has to be a change in attitude. For too long it has been regarded as an unfortunate disease of the poor and old which they have brought on themselves. Negative attitudes - that nothing can be done - pervades attitudes to the disease. We need to get away from that."

Unlike other cancers there had never been a powerful patient lobby for lung cancer victims because of their poor survival. They died too soon and the disease was consequently neglected.

A survey by Macmillan Cancer Relief found that almost a third of lung cancer patients had delayed going to the doctor for up to four months despite having symptoms including coughing up blood, loss of weight and chest pains.

Only a quarter were referred by GPs to a specialist within a week, as the guidelines on treatment dictate, and some waited more than a month for the diagnosis. More than half complained they had had inadequate care from the NHS.

The campaign was launched as the Government announced the cost of smoking to the NHS was between pounds 1.4bn and pounds 1.7 bn a year - more than twice previous estimates.

Tessa Jowell, the public health minister, said: "This is an appalling drain on the NHS and an enormous human cost to smokers ...

"We need tough action at both a domestic and European level to bring down rates of smoking."

Nicholas Young, chief executive of Macmillan Cancer Relief, said the campaign would aim to tackle the negative attitude to the disease which he described as the "forgotten cancer".

"High-profile anti-smoking campaigns engender guilt in lung cancer sufferers who become stoical and undemanding about their care. They are the largest group of cancer patients in the world and they are neglected."