BBC NEWS Americas Africa Europe Middle East South Asia Asia Pacific Arabic Spanish Russian Chinese Welsh

 You are in:  Health
Front Page 
UK Politics 
Background Briefings 
Medical notes 
Talking Point 
In Depth 

Commonwealth Games 2002

BBC Sport

BBC Weather

Wednesday, 21 November, 2001, 11:58 GMT
Q&A: The rising tide of lung disease
The British Thoracic Society - which represents thousands of lung experts - says that lung disease is now the biggest killer in the UK.

BBC News Online examines its claim that respiratory medicine deserves a bigger slice of NHS money.

What is respiratory disease?

These are illnesses which affect the lungs, throat and nasal passages.

These can vary from infections, such as pneumonia and tuberculosis, to allergy related conditions such as asthma.

Other diseases which fall into this category include cancers of the respiratory system such as lung cancer, and mesothelioma - the cancer caused by exposure to asbestos.

Thousands also suffer from smoking-related illnesses such as chronic-obstructive pulmonary disease (COPD) - a combination of chronic bronchitis and emphysema, which is progressive and fatal in many cases.

Aren't we always told that heart disease and cancer are the biggest health threats? What has changed?

This all depends on the way you count the number of deaths caused by each condition.

Heart disease was listed as the cause of just over 132,000 deaths in the UK in 1999, and cancer killed 144,801 in total.

Together, all lung disease deaths add up to 153,168.

However, this does include a little bit of double-counting - the lung disease deaths include the respiratory cancer deaths as well.

So, strictly speaking, lung disease is the biggest killer, although some might argue that it is wrong to count the cancers in this group.

In addition, if, as many do, you lump heart disease and stroke deaths together as "diseases of the circulatory system" - this tops the league by a mile.

Which lung diseases kill the most people?

In first place by some distance are deaths caused by pneumonia and influenza.

These are often opportunistic infections which strike at the very old or frail - the final straw perhaps, after a long-standing battle with another illness.

In 1999, 66,500 people died from these infections - the vast majority aged 75 and over.

Respiratory cancers - mainly lung cancer - accounted for almost 36,000 deaths. Survival rates for lung cancer are still very poor - and considerably worse than some other EU countries and the US.

COPD also kills more than 30,000 a year, and is a highly-disabling disease.

Why are lung specialists publicising the burden of lung disease?

They feel that their area is comparatively underfunded and ignored relative to heart disease and cancer.

While both coronary heart disease and cancer have been the subject of detailed national plans aimed at reducing the toll of death and disability, lung disease has not received such special attention.

The number of chest specialists, they say, is only a third of the EU average.

Deaths from lung disease in the UK are high compared to Europe - Ireland is the only EU country with higher death rates.

What could the government do to help the situation?

The government still argues that heart disease and cancer are its top priorities - and that these have to be tackled.

Deaths caused by heart disease, and cancer are more likely to happen slightly earlier in life, than deaths from pneumonia and influenza deaths - the bulk of which are in the over 75s.

Someone who dies from a heart attack at 65 might be said to have lost eight to 10 more years of potential extra life based on the average lifespan - compared to someone who dies from pneumonia at 75.

In strict terms of the "potential life years" lost to heart disease and cancer, the toll may well be higher.

However, the burden of disability from diseases such as asthma and cystic fibrosis, which are lifelong, is considerable.

It is somewhat unfair to suggest that it is doing nothing which will ease the toll of lung disease - many of the actions designed to tackle heart disease and cancer will have a knock-on effect on lung disease.

The most significant factor in the majority of cases of lung disease is smoking, and the government has spent millions on boosting smoking cessation services - allowing the prescription of drugs such as Zyban and nicotine patches.

While the shortage of doctors in chest medicine is particularly severe, there are shortages in many other specialties and ministers have pledged thousands more consultants entering the NHS over the next few years.

However, the British Thoracic Society says that legislation to ban tobacco advertising in the UK and extra regulation of workplace smoking could help.

See also:

21 Nov 01 | Health
'My fight against emphysema'
Internet links:

The BBC is not responsible for the content of external internet sites

Links to more Health stories are at the foot of the page.

E-mail this story to a friend

Links to more Health stories