Doctors looking at a lung x-ray
December 6, 2017

1 in 4 lung cancers are diagnosed via emergency presentation

New research shows too many cancers being diagnosed via emergency presentation and at a late stage

According to new research commissioned by the Irish Cancer Society 1 in 4 lung cancer cases are being diagnosed via emergency presentation.

In addition, at least 62% of all lung cancers present at a late stage (stage III or IV). Overall 15% or 3 in every 20 cancers during 2010-2014 were diagnosed via emergency presentation (excluding non-melanoma skin cancer). 

The analysis by the National Cancer Registry of Ireland, funded by the Irish Cancer Society, also shows that the major cancers with the highest proportion of emergency presentations for 2010-2014 were pancreas (34%), lung (26%), ovary (24%), colon (22%), lymphoma (17%) and oesophagus (17%). People with prostate (2.5%), breast (1.6%) and melanoma skin cancer (1.1%) are proportionately much less likely to present as emergencies.

Donal Buggy, Head of Services and Advocacy at the Irish Cancer Society said: “This preliminary research we have funded is immensely important as it is the first time in Ireland we have been able to see the proportion of cancers being diagnosed by emergency presentation.

“We already knew that 2 out of 3 lung cancers are diagnosed at a late stage, and now this research shows that 1 in 4 lung cancers - that’s over 600 cases of lung cancer a year - are being diagnosed in the emergency department. Out of those cases, unfortunately, in the majority, the patient’s lung cancer is already at Stage III or IV. Late diagnosis limits your treatment options and reduces your chances of survival.”

The research also showed that patients from the most deprived populations were 54% more likely to present as an emergency presentation across the top ten major cancers, compared with the least deprived populations. For lung cancer specifically, patients from the most deprived populations were 41% more likely to present as emergencies.

Mr. Buggy continued: “Lung cancer is the leading cause of cancer deaths in Ireland, with, on average, 1,855 people dying from lung cancer each year during 2012-2014. Late diagnosis is a significant contributory factor to this. Alarmingly, female lung cancer cases are projected to increase by at least 77% between 2010 and 2040 and male cases by at least 52%. In order to reduce lung cancer mortality in Ireland now, and into the future, we need to take urgent action to reduce the number of cancer patients diagnosed in the emergency department and at a late stage.”

Mr. Buggy said: “There are a number of specific targets aimed at increasing the proportion of lung cancers diagnosed early in the National Cancer Strategy 2017-2026. We want the Government, the National Cancer Control Programme (NCCP), and organisations like the Irish Cancer Society, to come together to take urgent action and implement concrete measures that will improve the earlier diagnosis of lung, and other cancers in Ireland, during the lifetime of National Cancer Strategy 2017-2026."

“To achieve this, up-front investment in the National Cancer Strategy is required in the HSE’s 2018 Services Plan, accompanied by strong actions on the number of people being assessed at Rapid Access Clinics within 10 working days, to achieve targets which are not currently being met.”

The Irish Cancer Society has funded further research from the National Cancer Registry of Ireland on the proportion of cancers diagnosed via emergency presentation which will be available in spring 2018.

The Irish Cancer Society announced the initial research findings to coincide with their Annual Charles Cully Memorial Lecture & Medal Award 2017, taking place 6 December, which this year is focusing on the late diagnosis of lung cancer, and measures to improve earlier diagnosis. 

Donal Buggy said: “This year, at our Charles Cully Lecture, we are honouring Professor Mick Peake, who throughout his career has worked tirelessly on the issue of earlier diagnosis of lung cancer, and improving outcomes for lung cancer patients. We are delighted he could come to Dublin to speak to us and offer some insights into success they have had on this issue in the UK. 

“We hope that off the back of today’s lecture, and Professor Mick Peake’s visit to Dublin, we can identify new ways for stakeholders including the NCCP, Department of Health and Irish Cancer Society, to collaborate to achieve the stated policy targets of the new Cancer Strategy and to increase the number of cancers diagnosed early”

Professor Mick Peake said: “Efforts to increase the proportion of patients whose cancer is diagnosed at an early stage should be central to any Government’s policy programme on cancer care aimed at improving survival rates. We know that the proportion of patients diagnosed by emergency alive one year later is less than a third of those who are referred electively by their GP.”

Professor Kerri Clough-Gorr, Director of the NCRI and Professor of Cancer Epidemiology at University College Cork added “We are delighted to undertake this research for the Irish Cancer Society. This is the first time in Ireland we have data on the proportion of cancers being diagnosed via emergency presentation. This is vitally important. The reality is you don’t want people presenting as an emergency.

Emergency presentation with cancer is generally associated with more advanced stage, fewer treatment options and poorer survival outcomes.  As well as this, it’s much harder on the patient as their symptoms are generally acute at this stage and it’s more expensive for the health system.”

Questions or concerns about lung cancer?

Visit our dedicated lung cancer section where we have information on tests and diagnosis, treatment and support options for patients and for families of those affected by lung cancer.

Contact our Cancer Nurseline Freephone 1800 200 700 to talk to a specialist cancer nurse about lung cancer.

Contact the NurselineLung cancer information