Results from the National Lung Cancer Audit (NLCA) in England and Wales have been published by the National Cancer Audit Collaborating Centre (NATCAN). The findings demonstrate improvements in early diagnosis across England and Wales but also highlight delays to treatment and ongoing variation in access to care.
The report1 analyses data for more than 39,000 people diagnosed with lung cancer in England and over 2,100 in Wales during 2024, providing the most comprehensive picture yet of lung cancer care across the NHS.
Key findings for England included:
- 40% of people were diagnosed at stage 1–2, up from 35.5% in 2023, driven largely by the expanding NHS lung cancer screening programme.
- Surgical treatment for non-small cell lung cancer (NSCLC) has risen, with 7,878 resections performed in 2024, a significant increase from 6,547 in 2023.
- 88% of patients with early‑stage NSCLC waited longer than the recommended 49 days from referral to surgery.
- Only 63% of patients with advanced NSCLC received systemic anti‑cancer therapy, falling short of the 70% NLCA standard.
- One‑year survival for patients diagnosed January-June 2024 was 50.7%.
Key findings for Wales included:
- Early‑stage diagnosis (stage 1–2) increased again to 34.8%, continuing a year‑on‑year rise.
- Curative treatment rates for early-stage NSCLC remained below the 80% standard at 77.8%.
- Systemic Anti-Cancer Therapy (SACT) rates for both advanced NSCLC and small‑cell lung cancer fell short of targets.
- The median time from referral to surgery was 91 days, exceeding optimal pathway recommendations.
Mr Douglas West, Thoracic Surgical Lead for the National Lung Cancer Audit, said: “This National Lung Cancer report demonstrates that more patients than ever are being diagnosed in the early stages of the disease, when curative treatment is often possible. In England, one in five people with lung cancer now undergo surgery. This is the highest proportion recorded, likely reflecting the positive impact of the national lung cancer screening programme. However, delays to treatment persist for many patients. Expanding treatment capacity is an important next step to improve services.”
Mr Tim Mitchell, President of the Royal College of Surgeons of England (RCS England), said: “This year’s audit shows encouraging progress in catching lung cancer earlier, but it also exposes the stark reality that our current system is struggling to keep pace with rising demand. Without investment in surgical capacity and treatment services, too many people will still face delays that can mean the difference between curative and palliative care.
"As the government rolls out its new National Cancer Plan, we need to make sure the NHS has the surgeons, theatre space and support services to treat patients quickly. Early detection only matters if we can act fast. This report is a clear reminder that we must move now to expand capacity and cut these harmful waits.”
Reference
1. https://www.natcan.org.uk/wp-content/uploads/2026/02/NLCA-State-of-the-Nation-Report-2026.pdf
