A ground-breaking health check programme which has saved lives across the city is re-starting after being put on hold during the Covid-19 pandemic.
The Liverpool Targeted Health Check ran successfully from 2016 until last year. In that time, it identified over 120 people who had lung cancer. Most of them were diagnosed with early-stage lung cancer and have since had curative-intent treatment.
Lung cancer is notoriously difficult to detect early. Its symptoms are often vague and easy to ignore or dismiss, particularly in the current situation. In many cases, symptoms only become obvious when the cancer has already spread. As a result, around 75% of people in the UK found to have lung cancer are diagnosed with terminal disease.
In Liverpool, the situation is even worse.
There were 2,616 new diagnoses of lung cancer in the city in 2014-18, or 523 new cases per year. Lung cancer incidence in Liverpool was 82% higher than expected when compared to overall figures for England.
Sadly, in most cases, the disease is incurable. However, when diagnosed at its earliest stage, almost 6 in 10 (57%) people with lung cancer will survive their disease for five years or more, compared with almost 5 in 100 (3%) people when the disease is diagnosed at the latest stage.
Targeted lung health checks, however, has the power to change this, revolutionising long term lung cancer survival rates by detecting it at the earliest opportunity, even before symptoms appear, and could cut lung cancer deaths by almost a third.
Dr Chris Warburton, Medical Director of Cheshire and Merseyside Cancer Alliance and Consultant in Respiratory Medicine at Liverpool University Hospital, said:
“NHS England’s Targeted Lung Health Check programme is a national programme to target those most at risk of lung cancer, in areas with the highest rates of mortality from the disease.
It is tremendous that the checks have now been resumed in Liverpool, with plans to roll the programme out over the coming months, firstly across Knowsley and Halton, and hopefully then to the rest of Cheshire and Merseyside.
I urge everyone eligible to have the check as it can diagnose many conditions, as well as cancer.”
Jo Shoba is one of over 100 people who have already been diagnosed through the programme. She felt well and had no symptoms when she went for her initial appointment. She was shocked when she was diagnosed with lung cancer even though she had not smoked in over 40 years.
She said: “I was in complete shock! How could I possibly have cancer? It just seemed so unlikely because I was so well. But that’s the thing with lung cancer, as I’ve since learnt. It doesn’t matter who you are, no one is immune. The aim of the lung health check is to pick up cases like mine at the earliest possible opportunity before symptoms have even appeared.
I count myself extremely lucky. Without this intervention my story would probably be very different. I would have known nothing about the cancer in my lung until the appearance of symptoms, quite possibly at a stage when treatment would be much more difficult. The care I received – from the initial health check appointment to the subsequent scans, the surgery and the recovery – was amazing, and I am so grateful to the NHS.”
Over 17,000 people attended a lung health check appointment in Liverpool before the programme was forced to pause last year, with nearly 7,000 people having a CT scan. Significantly, 72% of those diagnosed through the lung health check had early-stage lung cancer like Jo and were offered curative-intent treatment, turning current early detection rates on their head.
Dr Martin Ledson, Clinical Lead for Respiratory Medicine at Liverpool Heart and Chest Hospital, said: “Over the years, we have seen significant improvement in the early detection of many other cancers but not with lung cancer. Targeted lung health checks offer a way to change this. Without this programme, people like Jo many have diagnosed at a much later stage and could have had a very different outcome.
The lung health check scheme has also diagnosed people with many other conditions, including chronic obstructive pulmonary disease (COPD) and asthma, and even other forms of cancer, allowing them to get the appropriate treatment and care. That is why we are delighted to have now recommenced the programme and we can start inviting people back for a lung health check. The facts speak for themselves; it will save lives and we hope it will take us a step closer to a national lung screening programme.”
The programme has now relaunched, with residents registered with a GP in Everton, Anfield, Norris Green and Croxteth now being invited over the coming months. Those eligible will have a virtual appointment with a lung health check nurse where they will discuss their breathing and overall lung health. They may then be invited for a CT scan at either a local hospital or now in a mobile scanner, easily accessible within the heart of the community to make it even easier for people to access the lung health checks.
Dr Ledson said: “We appreciate that some people find it difficult to get to hospital or may even be a little nervous to come into a hospital environment in the current climate.
“After the last 18 months, the importance of respiratory health has never been greater, so we don’t want anything to get in the way of people attending a lung health check. We know the good these checks can do, the positive, life-saving impact they can have, so we’re excited we can bring the scanner to them so everyone who is invited can take up the opportunity.”
Jo Shoba added: “I know of people who have received an invitation and not followed it up. I can understand why – life’s busy, you forget to make the appointment, you think it’s not relevant to you, or maybe you’re a little frightened. However, my experience says – ‘You don’t know what you don’t know!’
There’s an onus on us to do our bit and if we’re being told it would be a good thing to have a check-up, then have it. If you value your health, why wouldn’t you have it checked?
I’m at the stage now where I can’t believe how lucky I have been. To be back, a matter of months since my operation, feeling fit and joining in with things that make up the fabric of my life, is pretty amazing.”
The Liverpool targeted Lung Health Check, which was formerly known as the Liverpool Healthy Lung Programme, is available to people aged 55-74 who currently smoke or have previously smoked. If you are eligible, you will receive a letter from the NHS inviting you to make an appointment.
For more information, visit https://www.lhch.nhs.uk/lung-health-check