More people in the uk die of cancer than any other disease, and lung cancer claims more lives than any other type of cancer. Our survival rates have lagged behind those of many other countries, prompting the government to set a target of reducing deaths from cancer by 20 per cent by 2010. Survival rates are steadily improving in most of the common types of cancer, including breast, bowel and ovarian cancer. But lung cancer remains the biggest cancer killer with 35,000 deaths each year. Fewer than 10 per cent of patients are still alive a year after being diagnosed.

I recently had the opportunity to attend an international meeting in Hong Kong at which cancer specialists and patient advocates discussed the barriers to improving treatment and outcomes for lung cancer in the UK, Canada and Australia. Lung cancer has a low profile relative to other types of cancer and as a result has attracted less investment in research and services for patients. There is a widespread belief that people with lung cancer have brought their illness on themselves by smoking. But we don't deny the best treatment to people who have injured themselves through driving or any other deliberate activity, and we shouldn't deny it to smokers. Following a recent decision the increased tax on cigarettes is ringfenced to support the NHS. Everyone who receives a diagnosis of cancer deserves the best treatment, and care, available and patients need to have confidence that the cancer care they receive on the NHS is of the same highest possible standard.

The consensus at the meeting I attended was that the single most important factor in ensuring the best possible outcome for each patient is rapid referral to a multi-professional team, which includes physicians, surgeons, oncologists, pathologists, radiologists and specialist nurses. This rapid referral ensures every patient is considered for the most effective treatment by the specialist, who will provide the treatment, and that the treatment is given at the time when it has the best chance of succeeding. This is the most important factor for all lung cancer patients, increasing the chances of cure where cure is possible, and ensuring that patients for whom cure is not possible - as their cancer is already widespread - are comfortable and active and able to make the best possible use of their last months of life. Lung cancer requires different treatments depending on how far the disease has spread and how well the patient is. The decision to offer surgery, chemotherapy, radiotherapy, supportive care, or a combination of these treatments, should be discussed by the whole team. And patients should receive adequate information to enable them to participate in decisions about their treatment and care.

The major barriers to providing this level of service are the delay between the patient's first visit to his or her GP and referral to a chest physician, and the shortage of doctors in each of the important specialities needed to treat these patients. A further barrier is availability of treatment. Although there has been an increase in the number of cancer specialists, radiotherapy machines, and funding for modern chemotherapy over the last two years, serious shortages are still compromising the level of care offered in NHS hospitals and adversely affecting patient outcomes. Cancer specialists are finding that only a small proportion of the funding allocated in the NHS Cancer Plan is being spent on improving cancer services, and that much is swallowed by overspend in other areas. There is great concern that when funding is channelled through Primary Care Organisations this problem will increase, as it is unrealistic to expect GPs to have detailed knowledge and understanding of cancer therapy, and to be able to make informed decisions on funding treatments. It takes at least five years full time training to become a specialist after qualifying as a doctor and completing the first two years basic hospital training, and it is necessary to continuously update that knowledge.

We know that successful businesses rely on long term planning to ensure continuing success, and doctors are well aware that they need to plan services on a 5-10 year cycle to ensure that the cancer services they provide develop to meet patients' needs most effectively. We must find ways to help provide this continuity to make the best use of our resources. One way of achieving this would be to pass a National Cancer Act, which would ringfence money for cancer research and services and allow sustained improvement.

If we hope to bring cancer services in the UK into line with western Europe, as stated in the NHS Cancer Plan, we must continue to invest in increasing the number of specialist staff, making available the most effective modern treatments and closing the gap between knowledge and practice.

The International Opinion Leader Forum for the Optimal Management of Patients with Non-Small Cell Lung Cancer (NSCLC) took place in Hong Kong from March 16-17