Publish date: 14 November 2022

A research study published in the medical journal Thorax has found that patients who get their chest X-ray results immediately are diagnosed in half the usual time.

Led by Dr Nick Woznitza, Consultant Radiographer at University College London Hospitals NHS Foundation Trust and Clinical Academic in the School of Allied and Public Health at Canterbury Christ Church University, the study hopes to benefit huge numbers of people with suspected lung cancer every year, shortening diagnosis time and improving patient experience.

The study recommends a National Optimal Lung Cancer Pathway (NOLCP) with rapid progression from abnormal chest X-rays to CT chest scans, preferably with a single patient attendance. The findings from the study, funded by Cancer Research UK, suggest that ‘immediate reporting by radiographers significantly shortened the time to diagnosis by around 31 days, cutting usual diagnosis and waiting time by half.

Dr Woznitza said: “We know that the early, rapid and accurate diagnosis of lung cancer will help improve outcomes for patients. By utilising the expertise of reporting radiographers we found that we could reduce the time to diagnosis by half by giving patients the results of their X-rays at the time they were taken, explaining the findings and arranging a CT chest scan, the next part of their journey.”

Results also show that radiographer reports, pioneered by Canterbury Christ Church University in 1994, are comparable to reports by consultant radiologists, supporting the use of trained radiographers to help increase reporting resources in the NHS.

The report was co-authored by Dr Bhagabati Ghimire, Lecturer in Epidemiology and Public Health at Brunel University, who said:

“I would like to congratulate Nick and team for this great work and its publication,” she said. “Lung cancer in most of the cases is detected quite late, reducing chances of survival. This study certainly sheds light on the steps we could take to reduce time to diagnosis and early detection of lung cancer as well as achieve the national 28-day standard for time from referral to diagnosis.”

Dr Nick Woznitza was awarded an MBE in the Queen’s New Year Honours List for services to the NHS, in particular for his clinical and academic leadership skills in diagnostic radiography in response to the Covid-19 pandemic. Nick’s clinical, research and teaching are focused on how we can improve outcomes for patients by increasing diagnostic capacity, including COVID-19 and lung cancer.

The findings of this study have been used to inform the design of an England-wide project to evaluate the use of Artificial Intelligence (AI) to examine X-rays. By using AI to triage suspicious chest X-rays, the trial aims to reduce the amount of time a patient has to wait from the first chest X-ray to cancer diagnosis.

Lung cancer is one of the most common causes of cancer deaths with around 47,000 people diagnosed with the condition every year in the UK. Some lung cancer cases are missed in chest X-rays because some lung nodules can be difficult to spot, however working with AI technology together with a healthcare practitioner could also pick up cases earlier.

The Small Business Research Initiative (SBRI) awarded £3.2m to fund the wider project led by Dr Woznitza and Professor David Baldwin, Chair of NHS England’s Clinical Expert Group for Lung Cancer, and which runs until June 2024. If the project demonstrates effectiveness, it could be introduced more widely across the health service.