AT the start of the pandemic, routine cancer screening was temporarily suspended. This coupled with patients’ reluctance to “bother” doctors and medics’ concern over referring patients at the height of a crisis created a perfect storm, which will sadly claim many extra lives over the next several years, due to late presentations and missing the window of opportunity to make an early diagnosis and commence treatment rapidly.

This is nowhere more clearly demonstrated than in the case of lung cancer, and it is not hard to see why. One of the main symptoms of both lung cancer and coronavirus is cough. Before the pandemic, a cough for more than three weeks, especially in a high-risk individual, would hopefully have triggered alarm bells for lung cancer. Yet since March 2020 many people with a cough have religiously followed the guidelines to self-isolate. Due to the strength of the public message, both clinicians and patients may have put Covid above cancer as their initial assumption, with individuals not coming forward even after a negative Covid test, despite the symptom persisting.

Lung cancer is a disease where timely diagnosis is of the utmost essence. Statistics show a five-year survival of just over 50 per cent if diagnosed at stage 1 (the earliest phase), with this dropping to a barely believable 3 per cent if diagnosed at stage 4. Yet in the UK, 75 per cent of lung cancers are diagnosed at an advanced stage. With 35,000 deaths annually, it outstrips the mortality figures for breast and bowel cancer combined. The UK Lung Cancer Coalition estimates at least 1300 extra lung cancer deaths in the next five years in the wake of the pandemic.

This is not only due to late presentation and diagnosis, but also certain treatments including chemotherapy, surgery as well as the provision of intensive care beds after a major operation being interrupted.

Sad news for a condition that has seen massive improvements in the last 15 to 20 years, including advances in treatment, significant expenditure in raising public awareness, and perhaps most importantly banning smoking in public places.

Cough is not the only symptom of lung cancer. Several other red flags include persistent chest pain, coughing up blood, shortness of breath and weight loss. Symptoms which you might not necessarily associate with lung cancer include a hoarse voice and swelling of the face and neck