Preventing diagnosis delays of lung cancer

Jodi Newton
Doctor diagnosing patient

Table of Contents

Lung cancer is one of the most common and serious types of cancer – sadly, it is often incurable. In common with other cancers, however, prompt diagnosis and early treatment of lung cancer will directly affect survival rates. I recall my first lung cancer misdiagnosis case in which my client’s first question was to ask why was he not offered more sophisticated investigations, over and above an x-ray, which would have achieved an earlier diagnosis which may have saved his life.

On 14 October 2021, healthcare safety organisation, Healthcare Safety Investigation Branch (“HSIB”) published its report detailing its investigations into factors which are contributing to high rates of misdiagnosis for lung cancer in England. HSIB research found that 5 year survival rates for lung cancer in the UK are one of the worst in Europe with two-thirds of patients diagnosed at an advanced stage.  Errors and discrepancies in radiology practice for diagnosing lung cancer have been recognised by HSIB as contributing to the poor survival rates.

Jodi Newton, a specialist medical negligence lawyer at Osbornes Law summarises the report and findings below.

Following the case of a patient who was a non-smoker and whose diagnosis was delayed as a consequence of a failure to identify lung cancer despite three chest x-rays, HSIB opened an investigation. In what they describe as the “reference event”, following the chest x-rays taken over a period of approximately 9 months, the patient was referred for a CT scan which identified lung cancer which appeared to have spread throughout her lungs. The hospital accepted that the findings on the previous x-rays suggested cancer was present but, sadly, this was not identified by the radiologist. The consultant referred the matter as a patient safety investigation and following an initial fact gathering exercise, HSIB authorised a national safety investigation.

The investigation found that:

  • Lung cancer in those who have never smoked is increasing.
  • That the media have created a strong campaign of messaging about the connection between lung cancer and smoking and as lung cancer has often non-specific symptoms, the adverse impact of this is that GPs have found it more challenging to diagnose.
  • While chest x-rays are usually the first test to assess for lung cancer, they are difficult to interpret and about one in five cancers are missed which is likely to falsely reassure the GP.
  • The evidence suggested NICE need to amend their safety net advice to healthcare professionals so that it is clearer what should be offered to patients with ongoing unexplained symptoms after a negative chest x-ray.
  • A CT scan for screening for high risk lung cancer patients is beneficial. Further research needs to be undertaken as to whether a CT should be the first-line diagnostic test in place of a chest x-ray.

HSIB made 3 safety recommendations to NHS Improvement, NICE, and to NHSX which were as follows:

  1. HSIB recommends that NHS England and NHS Improvement works with research partners to explore options for commissioning research to address whether CT scans are clinically more accurate and cost-effective for the diagnosis of lung cancer in symptomatic patients compared to chest X-ray.
  2. HSIB recommends that NICE reviews its current safety netting advice to healthcare professionals with respect to the investigation of possible lung cancer. The wording of the advice should be amended to make it clearer what should be offered to patients with ongoing, unexplained symptoms who have had a negative chest X-ray.
  3. HSIB recommends that NHSX develops guidance to support independent benchmarking and validation of artificial intelligence algorithms for the identification of lung diseases such as cancer.

That HSIB have recommended strategies to minimise error for diagnosis of lung cancer is a wake-up call to health professionals that this is a serious shortfall and one which can be improved by following HSIB’s advice. At the very least it warrants further research. A chest x-ray has now been highlighted as being an imperfect diagnostic tool and taking steps to minimise this error is likely to save lives from this particularly aggressive form of cancer.

It is also a development which has been well received by radiologists (represented by the Royal College of Radiologists) who support rolling out improved artificial intelligence to minimise diagnostic errors; however,  there is also a recognition that this may not be possible on the NHS due to limited resources including a shortage of staff, equipment, and consultants with the appropriate level of expertise.

If you believe that there has been a failure in care or delay of diagnosis in your case please contact Jodi Newton. She will be able to advise you of the medical negligence claims process, the NHS complaints procedure and whether you can bring a successful claim, on the facts of your case.

Jodi is ranked as a leading medical negligence lawyer in Chambers UK and the Legal 500. She is also an accredited lawyer of AvMA (Action against Medical Accidents). This accreditation means that Jodi has demonstrated a high level of skill and experience in handling medical negligence claims and caring for her clients.

To speak with Jodi call us or fill in the online form below.

Share this article

Contact

Contact us today

For a free initial conversation call 020 7485 8811

Email us Send us an email and we’ll get back to you






    • Emily Lund was very patient with our ignorance about the conveyancing process. She was consistently professional, cheerful and prompt. Thank you!

      Property Department Client

    • I would like to thank everyone in my case for the excellent job!

      Wills, Probate & Disputed Estates client

    • “Maria Kitsiou has excellent interpersonal skills and is very efficient. Her tireless dedication and hard work is appreciated.”

      Client review

    • "Kesha Pabari was the most kind, considerate and supportive lawyer, equally astute with due process and I would wholeheartedly recommend her."

      Divorce and Finances, client review

    • "William Ford is truly extraordinary - he helps everyone and knows the law better than anyone."

      Chambers UK 2023

    Insights from JodiVIEW ALL

    1. new born baby
      9.6.2023

      Early Notification Scheme – is it helping or failing...

      What is the Early Notification Scheme? The NHS Early Notification Scheme (“ENS”) has reached its sixth anniversary. Established in April 2017,...

      Read more
    2. The doctor looks at the x-ray
      9.11.2022

      Breast cancer screening mammograms and negligence

      Breast cancer screening has improved significantly in the UK due to research bettering the understanding of this terrible disease, which...

      Read more
    3. Pregnant woman performing cardiotocography CTG
      8.9.2022

      Poor interpretation of CTG can result in stillbirth...

      Poor interpretation of a Cardiotocograph, more commonly known as a CTG, is a leading cause of stillbirth and brain injuries...

      Read more
    4. Female surgeon wearing surgical mask
      14.4.2022

      Severe abdominal pain prolonged due to failed surgery

      Jodi Newton was instructed in a claim against London North West University Healthcare NHS Trust where our client suffered serious...

      Read more
    5. pregnant lady
      17.2.2022

      999 Call Handlers Maternity Instructions Report

      HSIB Report on Maternity Pre-arrival Instructions from 999 Call Handlers The Healthcare Safety Investigation Branch (“HSIB”) investigate NHS maternity incidents that...

      Read more
    6. Cancer treatment in a modern medical private clinic
      31.1.2022

      Recent cancer misdiagnosis negligence cases

      Osbornes Law specialises in helping families who have suffered due to a delay or missed cancer diagnosis. We represent clients...

      Read more
    7. cute kid with disability playing
      27.1.2022

      Recent cerebral palsy cases

      Osbornes Law specialises in helping families where a child has been diagnosed with cerebral palsy. We represent clients and families...

      Read more
    8. lesiones de nacimiento
      24.1.2022

      Likely settlement of £15-20 million for cerebral palsy...

      A client who suffered cerebral palsy injuries at birth was awarded £200,000 as an interim payment in a claim against NHS...

      Read more
    9. syringe
      15.12.2021

      Vaccine Related Blood Clots And Delays in Diagnosis

      Deep Vein Thrombosis, Pulmonary Embolism and Vaccine Induced Blood Clots The worldwide COVID-19 immunisation programme has been in full swing...

      Read more
    10. Doctor diagnosing patient
      12.11.2021

      Preventing diagnosis delays of lung cancer

      Lung cancer is one of the most common and serious types of cancer – sadly, it is often incurable. In common...

      Read more
    11. stethescope
      8.7.2021

      Failure to prescribe anti-coagulant medication proves fatal

      Executor of the Estate of DS and another v James Paget University Hospitals NHS Foundation Trust The Clinical Negligence team...

      Read more
    12. 18.5.2021

      Cerebral Palsy injuries suffered at birth likely settlement...

      A client who suffered cerebral palsy injuries at birth was awarded over £375,000 as an interim payment in a claim against...

      Read more
    13. doctor looking at microscope
      12.2.2021

      Patient Safety Investigations

      Duty of Candour Investigating incidents that have led, or could lead to harm is an important safeguard for patient safety...

      Read more
    14. 11.9.2020

      Osbornes Helps Client Who Suffers From Permanent Injuries...

      Jodi Newton, Solicitor in Osbornes clinical negligence team, settled a claim earlier this month for her client, who suffered a...

      Read more
    15. 2.9.2020

      Osbornes help family following a cancer misdiagnosis dating...

      Jodi Newton, clinical negligence solicitor Osbornes Law, recently settled a claim for the family of a lady who died from...

      Read more
    16. 24.7.2020

      Three-year-old girl with cerebral palsy who was given...

      A three-year-old girl with cerebral palsy who doctors thought would never walk took her first steps on day one of...

      Read more
    17. 10.6.2020

      Volunteering for AvMA – a formidable resource and important...

      Early in my career as a clinical negligence solicitor, AvMA, quickly caught my attention. AvMA is a charity and is...

      Read more

    VIEW ALL