Despite advancements in lung cancer management, early diagnosis remains paramount for improving patient survival rates. While oncology has witnessed significant progress in other cancers over the past four decades, lung cancer outcomes have not seen the same scale of improvement. A key factor in enhancing survival is diagnosing lung cancer at its earliest stages. Therefore, even with breakthroughs in effective treatments, achieving early diagnosis is crucial for optimal outcomes in lung cancer patients. This presents a significant challenge, as lung cancer symptoms are often non-specific and overlap with common benign respiratory conditions. General practitioners (GPs) bear a crucial responsibility in identifying patients at risk of lung cancer who require further investigation within the primary care setting.
Lung cancer diagnosis has historically depended on plain chest X-rays (CXR) prompted by symptoms. However, the sensitivity of CXR is less favorable compared to computed tomography (CT) scans. While some regions recommend low-dose CT (LDCT) screening for high-risk individuals, adoption remains limited, and eligibility criteria restrict its widespread use. Consequently, even with expanded screening programs, most patients will continue to be diagnosed after presenting with symptoms to their GPs. Achieving early diagnosis necessitates that GPs maintain a high level of suspicion and proactively investigate high-risk patients or those with persistent, unexplained respiratory symptoms. This article will explore the early detection of lung cancer from a primary care perspective, outlining key risk factors, the role of screening, and providing guidance on recognizing symptomatic presentations, investigations, and referrals for suspected lung cancer.
