Lung cancer isn’t as deadly as we thought? Not so fast…
Recent data demonstrates that early detection for lung cancer, shown to reduce mortality from lung cancer by at least 20% in the National Lung Screening Trial, can also identify tumors that are benign and do not need treatment. In the world of cancer early detection, this is a recurring issue across cancer types, including breast, prostate, and cervical cancers. (Read a summary in The New York Times here.)
However, this doesn’t change the fact that lung cancer kills more than 160,000 people each year, more than breast, prostate, and cervical cancers combined. Lung cancer accounts for more than 226,000 diagnoses each year. But, the majority of patients are diagnosed at late stage disease, based on symptoms rather than screening. The additional patients identified through screening with slow-growing tumors will likely add to that 226,000 – though hopefully not be accounted for in the 160,000 deaths each year. In fact, based on the original study results, that 160,000 will likely decrease with more widespread screening of individuals who fit the risk profile.
What does this mean for testing? It means we need more research, and more information for patients and doctors to make educated decisions about treatment options.
CT screening is just one tool we can use to determine a patient’s risk for a malignant, life-threatening lung cancer. Other risk factors include family history and environmental exposure, including smoking and radon exposure. Identifying additional biomarkers that are associated with malignancy is necessary to pinpoint which tumors identified by CT screening require intervention, and which should be monitored closely.
But for now, the good news is that we have a validated method to detect lung cancer early in some patients that is saving lives, and every patient whose life may be saved through early detection should get screened. Patients and doctors should discuss treatment options after seeing the results of screening, with a full discussion of the risks involved.
People who should be screened include:
*Thirty pack years corresponds to one pack per day for thirty years or two packs per day for fifteen years.
You can read more about lung cancer screening here: