Lung cancer is increasing in people who have never smoked, and media messaging highlighting the close link between lung cancer and smoking, as well as the often nonspecific symptoms of lung cancer, have created a significant diagnostic challenge for general practitioners, according to HSIB.

Although a chest X-ray is the recommended first test to assess whether a patient may have lung cancer, these images are difficult to interpret, and about one in five cancers are missed, the group stated.

A CT scan should be requested if there is uncertainty regarding pathology instead of a lateral chest x-ray. If in exceptional circumstances a radiologist requests a lateral chest x-ray, the same radiologist should provide the report, the HSIB said.