Shortness of breath and cough increase as first symptom of lung cancer

Lung cancer is the leading cause of cancer deaths in the UK and has a poor five year survival rate of around 13 per cent. Research led by the University of Exeter Medical School, published in the British Journal of General Practice, aimed to improve potentially life-saving early diagnosis through analysing which symptoms patients present first to their doctor. The team examined 27,795 records of adults who were diagnosed with lung cancer between 2000 and 2017, at more than 600 UK GP practices.

Over the 17 year period, the team found an increase in both cough and shortness of breath as the first symptom patients reported when they went on to be diagnosed with lung cancer. The study, funded by Cancer Research UK and supported by NIHR, found a decrease in patients who reported the first symptom to be coughing up blood, or loss of appetite, generally regarded as the headline symptom of lung cancer.

Professor Willie Hamilton, of the University of Exeter Medical School, who was an author on the paper, said: “Lung cancer is the biggest cancer killer in the UK. Our paper shows a rapid change in the first symptom doctors are seeing. That’s probably not caused by any change in basic biology, it’s more likely to be down to earlier detection.     

“It means teaching must change — clinicians must be alert to the risks of cough and shortness of breath.”

Sara Hiom, director of early diagnosis at Cancer Research UK, said: "This important study indicates that people are now going to the doctor about different symptoms of lung cancer, such as cough and shortness of breath, possibly because of awareness campaigns in the past. Most people with these symptoms will not have lung cancer, but it’s well worth letting your GP decide if you need tests - because if it is cancer, a prompt diagnosis and speedy treatment make all the difference. And although smoking makes it much more likely, remember that non-smokers can have lung cancer too."

The paper is entitled ‘Changes in the presenting symptoms of lung cancer from 2000–2017: a serial cross-sectional study of observational records in UK primary care’. Authors are Sarah Chowienczyk, Sarah Price and Willie Hamilton.