BREATHING IN A NEW ERA
A COMPARATIVE ANALYSIS OF LUNG CANCER POLICIES ACROSS EUROPE
Pharmacists can also help in identifying patients for assessment. A lingering cough can be
symptomatic of many things, but pharmacists may see someone repeatedly purchasing items such as
cough medicine.^28 If the pharmacist is suitably trained and aware, this can offer an opportunity to have
a discussion with the person or alert the primary care team.
Finally, we argue that LDCT screening programmes of high-risk populations should be considered.
We recognise that the challenges of implementing, funding and evaluating such programmes are
substantial. For example, the healthcare system would need to be able to manage the increased
number of patients diagnosed, and the screening programme would need to be supported by
primary care providers, although their current risk-assessment capabilities may often be lacking.^79
The increased awareness and availability of screening services among the public and among primary
care personnel may help to address unmet needs in the early detection of lung cancer.^80 We do not
recommend a yay or nay, we merely urge an evidence-based approach to informing the decision on
whether or not to implement LDCT screening programmes.Put patients front and centre, and ensure that they are
heard by decision makers
Improvements are needed in all aspects of a lung cancer patient’s journey from the first suspicion of
disease and screening through diagnosis and treatment. Healthcare systems can take the first steps
to address this by improving awareness of lung cancer and its tribulations among both the general
population and primary care health professionals. Understanding is a first step towards changing
behaviour.
Raising awareness can also be of practical help. The wide range of symptoms associated with lung
cancer mean that it is difficult to identify from early symptoms alone; clearly, communicating risk
factors can help to empower patients to ask their primary care physicians whether they should seek
screening. Relatively simple changes to care delivery can make a big difference. For example, running a
lung clinic can improve patient experience immensely by reducing stigma of attendance and improving
the co-ordination between the array of specialists that patients need to see.
Policymakers and system administrators also need to ensure that there are processes through which
the patient voice can be heard. The involvement of patient organisations in national assessments of
disease and policy development can help to build consensus. Occasionally such organisations are
disruptive too—but they tend to wield the creative disruption that healthcare systems need to go
through to move towards genuinely patient-centred care.Create systems to ensure sustainable and equitable
access to innovations
Recent medical innovations and technological developments have improved diagnostic and treatment
options for lung cancer patients. For people with the disease there are opportunities for improved
quality of life and longer survival. However, much of the new technology is expensive, and improved
and sustainable funding solutions need to be found to ensure that high-quality care is available for
patients. We described it as the “shock of the new ”, and as with any paradigm shift, there is a period of
transition as systems and structures struggle to re-orient themselves.