Can you ‘Spot the Difference’ ? Lung Cancer Awareness Month 2021

Photos of woman on a walk


November is Lung Cancer Awareness Month, an opportunity to shine a spotlight on the cancer that claims more lives than any other in the UK (approximately 35,000) per year [1]; this is more than the combined number of lives lost to bowel and breast cancer. This year for Lung Cancer Awareness Month, the Roy Castle Lung Cancer Foundation has launched its ‘Spot the Difference’ campaign, which highlights that the early symptoms of lung cancer may not be as obvious as many people think [2].

Lung cancer is the third most common cancer in the UK, with approximately 48,500 new cases diagnosed every year between 2016 and 2018 [1]. The majority (75%) of patients with lung cancer in the UK are diagnosed at an advanced stage of the disease [3], a statistic exacerbated by the COVID-19 pandemic, which has led to a hugely detrimental impact on the detection, diagnosis and treatment of all cancers. Lung cancer has been one of the worst affected; overlapping symptoms with the virus and the specific pressures placed on respiratory healthcare services due to the pandemic may have reduced timely detection of cases [3].

As with all types of cancer, early diagnosis is the key to improving survival rates, and therefore promoting awareness of the possible signs and symptoms continues to be the priority [2].

The symptoms of lung cancer can be subtle and easy to dismiss as something else; for example, breathlessness after a walk may be put down to being ‘a bit unfit’, and lack of energy may be attributed to a busy lifestyle and/or stress. By the time more specific, overt symptoms become apparent, the disease has often already spread throughout the lungs or to other parts of the body, which significantly reduces the likelihood of long-term survival [4]. For this reason, the ‘Spot the Difference’ campaign is encouraging people to recognise and act on differences from their ‘normal’ and to discuss these with their GP [2].

Spotting the symptoms [4–6]

If an individual is suffering from any of the following symptoms, they could be a sign of lung cancer until proven otherwise:

  • Persistent cough – if a new cough lasts for more than 3 weeks, or there is a noticeable change in a cough that has been there previously, it should be investigated
  • Breathlessness – initially this may only be noticed during activity, e.g. climbing stairs or taking the dog for a walk; however, if it’s unusual for the individual, it requires investigation
  • Fatigue – although many people are reluctant to present to their GP with tiredness, unexplained extreme tiredness or lack of energy should always be a trigger for seeking advice
  • Weight loss and loss of appetite – medical advice needs to be sought for unexplained weight loss of more than 5% over a 6- to 12-month period
  • Chest infections, chest pain and coughing up blood – if infections are recurrent and difficult to clear, this could be a sign of lung cancer; any coughed-up blood or blood in mucus needs further investigation

Less common symptoms include hoarseness, wheezing, difficulty swallowing, clubbed fingers, and pain in the shoulders and back.

How to reduce the risk of getting lung cancer

It is a rather sobering fact that in the UK, 79% of lung cancer cases are preventable. The majority of cases can be attributed to smoking, but exposure to carcinogens in the workplace, air pollution and ionising radiation are also important risk factors [7].

Stop smoking

Tobacco smoke contains 60 different carcinogenic substances. The more a person smokes and the earlier in their life they start, the higher their risk of developing lung cancer. Giving up smoking substantially reduces the risk of lung cancer over time, and it is never too late. After 10 years of not smoking, the risk of lung cancer reduces to half that of a non-smoker [7, 8].

Avoid passive smoking

Frequent exposure to other people’s smoke (passive smoking) can increase the risk of developing lung cancer by around 30% [9]. The smoking ban enforced in the UK in 2007 has made it much easier for non-smokers to avoid second-hand smoke. In addition, up to two million people have given up smoking since the ban, and smoking has become far less socially acceptable [10].

Be aware of potential environmental and workplace risks

Inhaling chemical or mineral particles as a consequence of working in certain industries or trades, e.g. construction (asbestos and silica dust), professional driving/mechanic (petrochemicals), car body shop repair (spray paint) and pesticide production (dioxins), can also increase the risk of lung cancer [11].

Some risk factors are more difficult to avoid, such as outdoor air pollution (although we can all take responsibility for helping to reduce this), radon gas exposure in certain areas, previous cancer treatment with radiotherapy, a family history of lung cancer, increasing age and lowered immunity [7, 12]. This makes it even more important to address the risk factors that we can avoid.

So, this November for Lung Cancer Awareness Month, please spread the word (perhaps by sharing this article) to help everyone Spot the Difference and identify the sometimes subtle symptoms of lung cancer so that more people can be diagnosed and treated promptly to maximise their chance of survival.

The information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general information purposes only. Always seek the guidance of your doctor or other qualified healthcare professional with any questions you may have regarding your health or medical condition.


  1. Cancer Research UK. Lung cancer statistics: Lung cancer mortality. Available at: Accessed November 2021.
  2. Roy Castle Lung Cancer Foundation. Spot the Difference. Available at: Accessed November 2021.
  3. Gourd E. Lung cancer control in the UK hit badly by COVID-19 pandemic. Lancet Oncol 2020; 21 (12): 1559.
  4. National Health Service. Symptoms: Lung cancer. Available at: Accessed November 2021.
  5. Roy Castle Lung Cancer Foundation. Spot the symptoms. Available at: Accessed November 2021.
  6. Macmillan Cancer Support. Signs and symptoms of lung cancer. Available at: Accessed November 2021.
  7. Cancer Research UK. Lung cancer statistics: Lung cancer risk. Available at: Accessed November 2021.
  8. National Health Service. Prevention: Lung cancer. Available at: Accessed November 2021.
  9. Kim CH, Lee YC, Hung RJ et al. Exposure to secondhand tobacco smoke and lung cancer by histological type: A pooled analysis of the International Lung Cancer Consortium (ILCCO). Int J Cancer 2014; 135 (8): 1918–1930.
  10. Cancer Research UK. British smokers down by 1.9million since the ban. Available at: Accessed November 2021.
  11. Croner-i. Lung cancer — reducing the risks. Available at: Accessed November 2021.
  12. Cancer Research UK. How can air pollution cause cancer? Available at: Accessed November 2021.

Author: Suzanne Brunt BM | Medical Writer | Porterhouse Medical