How under-funded is lung cancer research?

 
Coloured chest X-ray showing lung cancer in frontal view Funding for lung cancer research is a fraction of that for other cancers

The Today Programme this morning highlighted a new initiative to coordinate lung-cancer research in London, with a view to increasing the availability of targeted, genetically personalised therapies for lung-cancer.

As you may know, this is an issue close to my heart, because my wife, the writer Sian Busby - a lifelong non-smoker - died of lung cancer at the age of 51 in September (which is why this is a slightly different blog from many I write).

So how under-funded is lung cancer research? This is an issue I looked at in a recent film for the One Show, but here is a bit more granular detail.

The first set of stats relate to how lethal it is.

Lung cancer accounts for around 13% of all cancers in the UK and 22% of cancer deaths, according to Mick Peake, the clinical leader of the National Cancer Intelligence Network.

So that's 42,000 new cases identified every year, and around 35,000 deaths.

Survival rates

To put that into some kind of context, the next biggest cancer killer is bowel, which accounts for just under 16,000 mortalities per annum and then breast, which kills under 12,000 a year.

What is also striking, and horrifying, is how quickly lung cancer kills sufferers.

Recent figures from the Office of National Statistics show that 83.3% of breast cancer sufferers are alive five years after diagnosis, just over 51% of bowel cancer sufferers live at least five years and 79% of prostate cancer sufferers survive five years.

In stark contrast, the five year survival rate for lung cancer is 8.8% for women and 7.4% for men.

Here is perhaps an even more chilling number: according to the ONS more than 70% of lung-cancer sufferers are dead in less than a year after diagnosis.

Now according to experts, such as Mick Peake, there are two reasons why lung cancer is such a savage killer.

One is that we are lousy in the UK at catching and diagnosing the disease before it becomes inoperable: cutting the cancer out through surgery is still the most effective way of prolonging life.

For reasons which the clinicians say are hard to fathom, parts of Scandinavia are significantly better at achieving early diagnosis of the disease - so lung-cancer sufferers there have much greater life expectancy than in the UK.

Prevention

The simple thing that needs to happen, according to the experts I filmed for the One Show, is that those who have a prolonged cough - whether smokers or non-smokers - need to be sent for an X-ray on a more routine basis than currently happens in the UK.

The second reason why lung cancer is such a killer is that funds spent on research are a fraction of what they are for other cancers.

The main source of data on this is published by the National Cancer Research Institute, which receives information on cancer research spending from 22 organisations responsible for most cancer research in the UK.

Those who supply this information include Cancer Research UK (the most important research organisation), the Department of Health, Wellcome Trust and the Association of the British Pharmaceutical Industry.

This showed that in 2012, breast cancer received research funding of £41m, Leukaemia received research funding of £32m, bowel cancer received £35m, Prostate cancer got £21m and lung cancer - remember it is the biggest killer - got less than £15m.

And nor was 2012 untypical. Lung cancer has received significantly less than these other cancers have secured for research in every one of the 11 years of data published by the NCRI.

Historic reasons

There is a starker way of seeing this funding disparity.

Breast cancer receives just over £3,500 of research funding per death from the disease. Leukaemia receives over £7000 of research funding per mortality.

Lung cancer receives just over £400 per death.

So why has lung cancer research received so little funding?

Part of the explanation, historically, has been prejudice - according to researchers struggling to win research backing for lung-cancer projects.

There has been a perception that lung cancer sufferers have only themselves to blame, because they've smoked all their lives, and they tend to be old.

But this perception is wrong. The median age of diagnosis for lung cancer is 72, but with 42,000 diagnosed every year there are many thousands of sufferers who are much younger.

Non smokers

Of course there is a strong causal link between smoking and lung cancer. But is depriving smokers of help and hope tantamount to saying that addicts of all sort should be left to rot - which most people presumably say would be an appalling attitude?

However experts have also said to me that they have historically over-estimated the link between smoking and lung cancer.

Mick Peake, for example, says that around 10% or men and 15% of women who have the disease are people - like my late wife - who have never smoked. Others say that around 20% are never smokers.

So that is, as a minimum, more than 5,000 new cases per year in people who have never smoked and around 4250 deaths.

Resources

Here is the thing: the total amount of lung-cancer research in the UK equates to £3,500 per never-smoked lung cancer death, more or less the same as for breast cancer - which you might see as implying that as a society we have chosen not to devote any research resources to saving smokers.

Even if you think that is a correct societal judgement, as was pointed out on the Today Programme, many thousands of lung cancer sufferers gave up smoking years even decades before diagnosis.

However, it is not just stigma that has led to the under-funding of lung cancer. It is also that with so many sufferers being diagnosed too late for surgery, there hasn't historically been as much tissue available to researchers to carry out the kind of genetic research necessary to develop effective targeted treatments.

Which is why any serious progress in treatment and care of lung cancer requires a combination of better and earlier diagnosis with a more adequately funded research effort.

 
Robert Peston, economics editor Article written by Robert Peston Robert Peston Economics editor

Why Coe is set to win BBC race

Why Lord Coe is likely to be next chairman of the BBC Trust, but he may be its last chairman (at least of the Trust as currently configured).

Read full article

More on This Story

Comments

This entry is now closed for comments

Jump to comments pagination
 
  • rate this
    0

    Comment number 126.

    #125 Nearly all smokers and ex-smokers have a persistent cough. Most ex-smokers do not have discernable lung cancer. Routine annual X-rays are not cost-effective or risk-effective. CT scans even higher dose.
    So, how to diagnose clinically early ???

  • rate this
    0

    Comment number 125.

    There are two issues: lack of research, but also lack of awareness. Late diagnosis is a big problem. Research can improve treatments but not get people diagnosed sooner, so awareness campaigns are needed too. As Robert says, earlier diagnosis will aid research by increasing resections. Funding research is only part of the solution - better public health funding is needed too.

  • rate this
    0

    Comment number 124.

    Sorry for your loss Robert. I know from watching my mum sucumb to it what terrible, devastating illness lung cancer is.

    Matters of a cure aside, you would think lung cancer would be one of the easier cancers to diagnose with the new tests that are being developed on based on the analysis on breath?

  • rate this
    0

    Comment number 123.

    I didn't know about your wife, I'm sorry. I'm guessing it has to be possible for non smokers to get it. But it is obviously much more common in smokers. Good luck with the fund raising.

  • rate this
    0

    Comment number 122.

    Self evident - Lung cancer is perceived as a mainly MALE disease, breast cancer is mainly a female disease(some men get it), leukaemia is seen as a disease of children. It is a pattern throughout the health service. A few years ago I took a cancelled appt to see my GP, my first for over 9 yrs he observed. It was during a 'well woman' clinic & I had a skin cancer!

  • Comment number 121.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    0

    Comment number 120.

    One problem is that research into non-smoking Lung Cancer is obscured by the greater numbers of smoking LCs, and overlaps including those like Roy Castle who are assumed to have LC due to exposure to other people's smoking. Small bumps are easier to see against a flat base-line. Research would have to concentrate on communities where few smoke: Amish, nuns, Mormons ?

  • rate this
    0

    Comment number 119.

    It was a good article on R4..

    Those diagnosed with lung cancer aren`t around long enough in the main to create much of fuss or raise awareness..

    One of the main things I remember is Roy Castle and his diagnosis of lung cancer, which he attributed to passive smoking, which may or not have been true, not to disrespect his memory or belief, yet, lung cancer is tarred with the smoking stigma..!?

  • rate this
    0

    Comment number 118.

    Beggars me, that as a race. We hinder and slow our mutual advancement over this thing we call money.
    Just imagine research being given a blank cheque, how much we could achieve.
    Yet today life saving equipment gathers dust in a warehouse because the health authority cannot afford it.
    New drugs also not issued due to costs.

    Time to make money no object and have a more moral society.

  • rate this
    0

    Comment number 117.

    111.BtH

    One of the main reasons for the variation in success rates is ease of identification. Pancreatic cancer is often enough diagnosed post-mortem. It's difficult to research under those circumstances. A big practical problem.

    Nor is it ever going to be an easy organ to gain support for. Many people don't even know what it does. The best hope is an accidental discovery elsewhere.

  • rate this
    0

    Comment number 116.

    Austerity in the EU has been barnstormed and brings havoc. This is because there was. Financial set back underway when member states climbed into the straight jacket which Merkle refers to as balancing the books with Stability pact. UK wisely stepped over that puddle. http://en.wikipedia.org/wiki/European_Fiscal_Compact

    It redistributes wealth as did Hartz 4, and is destroying now 15% pa demand

  • rate this
    0

    Comment number 115.

    H&V 1986 ~ http://m.nber.org//papers/w1632
    F,F&R 2013 ~ www-3.unipv.it/websiep/2011/201168.pdf

    This is the politics of economics and replication today is the name of the empirical game. The US mandate is for full employment, however thise creating wealth are tax averse and causing fiscal imbalances.

    Should people starve to maximise profits when this is inefficient, empirically.

  • Comment number 114.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    0

    Comment number 113.

    There should be no tobacco duty.
    There should be no sales.

    .

  • rate this
    +1

    Comment number 112.

    It seems to me that there's a strong argument for diverting some of the tobacco duty to fund lung cancer research (and other smoking related cancers) thus avoiding having to tackle the societal issue of funding a perceived self inflicted disease.

    Of course there's plenty of serious health problems with strong links to individuals' lifestyle choices,

  • rate this
    +1

    Comment number 111.

    #109 Some cancers have been picked off. The increase in survival in testicular cancers, for example. Childhood leukaemia has made very significant advances. Some other tumours have made little progress: brain gliomas and pancreatic cancer.
    The research strategy is to keep a few small groups in each field, then reinforce the winners heavily if they come up with results.

  • rate this
    0

    Comment number 110.

    ..A few observations from one who has seen the effects of LC at close hand.
    Knows too much about the effects.
    The lungs are am incredibly sensitive part of the body.
    They are daily exposed to harmful substances.
    Some natural and unavoidable.
    Some manmade. Avoidable.
    For some to profit out of this is unconscionable.
    For this to skew funding is also perverse.
    But it happens.
    It shouldn't do so.

  • rate this
    0

    Comment number 109.

    I recall as a teenager in the 1970's the Cancer Research campaign was a big thing back then, in my mind anyway. It seemed we were told, what with the research and funding, we would make good progress, in terms of treatment. Those involved were "confident." Sad to say the confidence back then hasn't matched up to the reality today? Hopefully we are getting closer though. Maybe with genetics?

  • rate this
    0

    Comment number 108.

    "The reason that lung cancer has such a poor outlook is because patients present very late"
    Obviously, if you are diagnosed earlier you will live longer merely because you have moved a length of time from 'blissful ignorance' to 'diagnosed, survival'. Figures that prove early diagnosis significantly increases real survival are sparce. Cure is rare. Remember John Wayne 'I've beaten the big 'C'.

  • rate this
    +1

    Comment number 107.

    rajagr@104
    "begrudge treatment"
    Robert's issue 'begrudging' of research
    For sufferers, issue not 'willing', but 'too late' / 'unfit'

    Kin@101
    "morally corrupt"?
    As smoke-cancer & totals fall, non-smoke proportion rises
    US male smoke-cancer peak passing (dying out)
    Later tsunami, female, still breaking (longer-lived)
    Tragic any young tempted to ignore advice

    103"red herring"No. But pollution rise

 

Page 1 of 7

 

Features

BBC © 2014 The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.