Limited diagnostic yield of urgent haemoptysis referrals to lung cancer clinics

<bold>Background:</bold> Haemoptysis is a critical sign prompting urgent referrals to lung cancer clinics due to its perceived link with malignancy. However, uncertainty remains about the actual rate of lung cancer diagnoses and the risk of over-investigation. Guidelines advocate tailored imaging, such as CXR, CT scans, or bronchoscopy, based on individual assessment. <bold>Methods/Results</bold> A retrospective analysis of 104 patients referred to a Saint James rapid access lung cancer clinic over 12 months revealed low lung cancer diagnoses (8.6%). 8/9 cases with lung cancer had all abnormal CXRs, recurrent haemoptysis, and were smokers. A singular non-smoker, with once-off haemoptysis and a normal CXR, demonstrated a CT-revealed peripheral adenocarcinoma possibly incidental. Diagnoses were primarily made through bronchoscopy or CT-guided biopsy. Notably, ongoing nodule surveillance was needed for eight patients. <bold>Discussion</bold> The study raises concerns about alternative diagnostic approaches, especially for non-smokers, given the low yield of lung cancer diagnoses in haemoptysis referrals. CXR's efficacy as a screening tool for low-risk patients, especially non-smokers, is highlighted, but interpreting abnormalities requires caution. The correlation between nodules and haemoptysis warrants further scrutiny due to the potential for incidental findings. Limitations include advocating for a larger sample size and deeper understanding of haemoptysis, promoting judicious clinical judgment. This abstract summarizes the study's key findings, limitations, and implications for the assessment and management of haemoptysis referrals to lung cancer clinics