lung cancer is leading cause of cancer death in NZ

5 yr survival - 10.2% compared to 13% in austalia and 15% in USA

• more patients presented to secdonary care via acute admission (36%)

  • compared to GP 29% and via OP referral

• patients via ED had more advanced, incurable disease

• Dx and Rx subject to lengthy delays

  • particularly noticeable in OP

• 28% were presented at a thoracic MDT meeting

• Rates of delivery of anticancer treatments low

• below comparable courntries

• Maori 2.5time more likely to have locally advnceed disease

  • 4times less likely to receive curative rx compared to europeans

referral

• urgently referred (within 2 weeks)

  • persistent haemoptysis and are smokers/ex-smokers aged ≥ 40yo

  • CXR suggestive of lung cancer

    • including plueral effusion and slowly resolving consolidation

• referred for CXR if:

  • unexplained haemoptysis

• or

  • any of the following unexplained, persistent (lasting > 3wks or ≤ 3 wks with risk factors -( smokers, copd, asbestos, history of cancer):

    • chest and / or shoulder pain

    • SOB

    • weigh loss/loss of appetite

    • abnormal chest signs

    • hoarseness

    • finger clubbing

    • cervical and/or supralavicular lymphadenopathy

    • cough

    • features suggestive of metastasis from lung cnacer (brain, bone, liver, skin)

• CXR should be completed and reported within 1 week

• repeat CXR 6 weeks to ensure resolution with consolidation

  • if

    • smoker

    • copd

    • asbestos

    • history of cancer - especially head and neck

• sputum cytology not recommended for investigation of lung cancer