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Tens of thousands of patients with lung cancer in the United Kingdom are missing out on targeted treatment that could improve their prognosis due to delays in genomic testing, a new report has warned. The UK Lung Cancer Coalition (UKLCC) said these delays persist despite a government commitment to embed genomics across the NHS.

Genomic testing, which analyses the DNA of cancer cells to identify specific mutations, is now a critical part of lung cancer diagnosis and treatment. By identifying individual tumour mutations, patients have access to a growing range of innovative and personalised treatments, thereby improving survival rates.

Testing Delays Affect Outcomes

The recommended turnaround time from tissue biopsy to full genomic results is 14 days. However, patients in some regions faced delays of several weeks, according to the report, Faster Testing, Better Outcomes: Genomic Testing in Lung Cancer.

These findings align with Lord Darzi's 2024 report on the state of the NHS in England, which found that although more than 35,000 genomic tests were being completed each month, only 60% of results were delivered on time.

Delays Cause Harm

Due to extended wait times and significant resource challenges within the NHS, only 60% of patients with lung cancer in England start treatment within 62 days. Those eligible to receive modern, targeted treatments often face the longest delays due to the need for further tests to determine the best course of treatment.

"This situation is wholly unacceptable, causing significant physical and mental harm to patients who, after receiving a devastating diagnosis, must endure prolonged waits before starting the most suitable treatment," said Robert Rintoul, professor of thoracic oncology at the University of Cambridge, Cambridge, England, and clinical lead for UKLCC, in a press release. "Lung cancer is a rapidly fatal disease, so timely access to test results and effective treatments is essential," he emphasised.

Each year, around 30,000 UK patients with lung cancer have tissue samples sent for genomic analysis. Reducing turnaround times to the 14-day target could improve outcomes, the report said. However, several challenges contribute to delays, including a lack of published turnaround data from genomic laboratory hubs, inconsistent sample quality, variations in results reporting, outdated IT systems, staff shortages in laboratories, and inefficient transport logistics. Some tissue samples were even sent via second-class post, further slowing the process.

Report Recommendations

To speed up genomic testing, the report recommends:

• Planning biopsies to ensure high-quality tissue samples for testing.
• Faster collaboration between pathologists and genomic scientists.
• Daily transport services between pathology labs and genomic hubs, alongside a digital tracking system.
• Reducing turnaround targets for lung cancer genomic tests to 7 days.
• Standardising report templates and providing clinicians with a single online platform for rapid access to results.
• Assigning a named individual at each pathology and genomics lab to oversee the testing pathway and ensure accountability.

UK Survival Rates Remain Low

Lung cancer is the United Kingdom’s leading cause of cancer death, with more than 43,000 people diagnosed each year in the United Kingdom. Survival rates vary widely, but 1-year survival stands at about 40%, while 10-year survival is only 10%, according to NHS data.

The report found that survival rates in the United Kingdom were "poor" compared with similar European countries. It pointed out that although early diagnosis can lead to a cure, over one third (35%) of diagnoses in England occurred via emergency hospital admissions.

Rintoul, who co-authored the foreword to the report, said that faster genomic testing could streamline treatment pathways, avoid less-effective treatments, and ultimately reduce costs for the NHS.

Foreword co-author David Gilligan, consultant clinical oncologist at the University of Cambridge and Royal Papworth Hospital, Cambridge, England, said that no patient diagnosed with lung cancer should wait more than 14 days for genomic test results. "We owe it to our patients to ensure they receive the most appropriate and effective treatment as swiftly as possible."

The UKLCC is sponsored by AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Johnson & Johnson, Lilly Oncology, Merck Group, MSD, and Roche.

Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.