Lung disease should be prioritised

Every five minutes in the UK, one person dies from lung disease, a statistic that underlines the massive impact of conditions such as COPD, chronic asthma and lung cancer. Yet, despite the fact that lung disease is one of the three big killers in the UK, alongside cancer and cardiovascular disease, it comes a very poor third compared to the other two. Investment in research is far lower and efforts to tackle lung disease by the NHS and other public bodies lags well behind these other disease areas. The systematic neglect is reflected in the fact that the number of people dying from lung disease has barely changed in a decade whereas the number of deaths from cardiovascular disease fell by 26,000 between 2008-2012.

So why is this disease area not given the attention it deserves? Some people suggest that it may be because lung conditions are chronic and uneventful, unlike heart attacks and strokes which can come from the blue and create a life-threatening emergency. But I beg to differ. Asthma, which is becoming an epidemic in this country, can leave someone fighting for breath in an instant. You only need to be exposed to the wrong allergen at the wrong time, and you can be dead.

I recently treated a lady with COPD who was getting better in hospital and was due to be discharged in a couple of days time. She caught an upper respiratory infection and died 24 hours later.

It may be time to rebrand such lung emergencies as ‘lung attacks’ so people could start seeing them for what they really are – serious crises which are just as dangerous as heart attacks or strokes. At least then, policy makers might look again at better ways to tackle lung disease.

Professionals also have to change the way they view people with lung disease, who often accept their situation as normal and don’t make a fuss. We should be proactive and aggressively investigate for signs of early disease. It is a well established fact that COPD which is caught early is far easier to treat and can even be reversed. At the moment in the UK, most cases of COPD are diagnosed at very late stage when little can be done beyond palliative care.

Just because someone is quiet and uncomplaining, it doesn’t mean that their situation is not critical. Even people suffering a severe asthma attack may be missed and told to go home and take a puff of a relieving inhaler. The fact is that 90 per cent of asthma deaths are avoidable and preventable. If clinicians focused more on getting patients to take steroid inhalers as a preventative, rather than doling out relievers like salbultamol, the death rates would fall.

We have the evidence that lung disease is killing people but there is also plenty of evidence that there is a lot more we can do. The government is doing amazing things when it comes to encouraging smoking cessation, but now it needs to boost research and disease prevention too. The British Lung Foundation have made several recommendations which I whole heartedly support including establishing a Taskforce for Lung Health (following recent task forces for cancer and mental health and setting up a NHS Clinical Network for lung disease to integrate care an reduce regional variation. Such networks already exist for cancer and cardiovascular disease.

If we can create a level playing field for lung disease we should see the benefits in the long-term decline in death rates and improved quality of life for thousands of people.

Dr Richard Russell

Dr Richard Russell
Consultant Chest Physician
Editor in Chief
Int J of COPD

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