Referral information and guidelines

GP referral guidelines

Lung cancer is the third most common cause of death in the United Kingdom and has an annual incidence of 35,000 cases and a similar number of deaths each year. Lung cancer accounts for about a quarter of all cancer deaths and 80 percent of patients die within one year of diagnosis. The majority of the cases are in current or ex-smokers.

Predominant symptoms/signs at presentation

Any of these symptoms should raise the possibility of lung cancer:

  • Haemoptysis

  • Unexplained or persistent ( > 3 weeks)

    • A cough

    • Breathlessness

    • Wheeze or stridor

    • Chest/shoulder pain

    • Weight loss

    • Hoarseness

  • Abnormal chest signs (esp. unilateral)

  • Signs of SVC obstruction (swelling of neck/face with fixed elevation of JVP)

  • Features suggestive of metastases (e.g. brain, bone, liver, lymph node)

  • Finger clubbing

In most cases, it is appropriate to arrange an urgent chest X-ray before referral to a chest physician.

Chest X-ray

  • Abnormal in the vast majority of symptomatic lung cancer patients

  • Patients with suspicious chest X-rays will be automatically referred to a chest physician (unless GP specifically requests otherwise)

  • Normal chest X-ray does not exclude lung cancer

Urgent referral to chest physician

  • Normal chest X-ray but high clinical suspicion of lung cancer (e.g. persistent haemoptyses in smoker / ex-smokers)

  • Abnormal chest X-ray in the patient not automatically referred to chest physician by X-ray department

  • Symptoms / signs needing urgent assessment (e.g. SVC obstruction) 

Information for hospital doctors

Our specialists have access to advanced diagnostic equipment, specialist thoracic and cardiac theatres, and excellent rehabilitation and recovery facilities.

Our diagnostic and treatment options for benign and malignant conditions of the chest include:

  • Surgery for lung cancer and other thoracic malignancies (such as mediastinal tumours) and secondary lung cancers (metastasectomy)

  • Surgery for diseases of the airways including endobronchial resection and stenting

  • Minimal access (keyhole) surgery

  • Surgery for emphysema (LVRS)

  • Pneumothorax surgery

We also provide surgical palliative or symptom-control procedures.

Healthcare professionals regularly approach us for specialist second opinions on complex cases.


Royal Brompton Hospital is also a designated thoracic sarcoma surgical centre for London and South East England and an internationally renowned centre for thoracic neuroendocrine tumours.


We specialise in cryosurgery where conventional thoracic surgery is not an option. Read more about cryosurgery and our cryosurgery research


To refer patients to us, please contact one of the thoracic surgeons or respiratory physicians at Royal Brompton Hospital or Harefield Hospital directly.

See the list of our consultants.

We see NHS patients and private patients.