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Updated lung cancer guidance published by NICE


Updated guidance on the diagnosis and treatment of non-small-cell and small-cell lung cancer has been published by NICE.

New recommendations are largely focused on secondary care but the guideline is relevant to all healthcare professionals with an interest in the diagnosis and management of patients with lung cancer, including those in primary care.

The update takes into account new trials and systematic reviews that have provided new evidence in the areas of staging, radiotherapy and systemic treatment. It also outlines the follow-up, support and palliative care interventions that should be available to patients.

The importance of early diagnosis of lung cancer guideline is emphasised by the guideline. It says that the public needs to be better informed of the signs and symptoms of early lung cancer through coordinated campaigning to raise awareness. Recommendations on referral for suspected cancer are covered in a separate guideline.

There is also a section on stop smoking interventions and services. NICE recommends that people should be advised to stop smoking as soon as a diagnosis of lung cancer is suspected and told why this is important.  People should be offered nicotine replacement therapy and other therapies to help them to stop smoking.

Healthcare professionals in primary care can use the PCRS Guide to Diagnosing and Managing Tobacco Dependency to support patients to stop smoking.  

Carol Stonham, PCRS Vice-Chair and member of the UK Lung Cancer Coalition Clinical Advisory Group, said:  “The updated NICE guideline emphasises the need for early diagnosis of lung cancer to improve survival rates. In primary care we need to always consider lung cancer as a diagnosis, both in those people presenting with new respiratory symptoms and those with an established diagnosis but worsening symptoms.
“The guideline also reinforces the importance of treating tobacco dependency if lung cancer is suspected but helping people to quit smoking at every opportunity will help in preventing lung cancer and other smoking related illnesses. The benefits cannot be over emphasised."