Lung Cancer Screening--from the International Association for the Study of Lung Cancer

November is Lung Cancer Awarenesss Month and IASLC has issued some valuable talking points that could be useful for lung cancer screening with patients, colleagues, and the general public.

 

1. Lung Cancer is the #1 cancer killer in the world, killing more people than breast, colorectal and prostate cancers combined. 
2. Recent advances in Lung Cancer Screening and Early Detection are providing hope for patients and their families that has never before existed in the field of lung cancer. 
3. The potential for saving lives through lung cancer low-dose computed tomography (LDCT) screening will dramatically change the disease statistics in the coming years. 
4. Most patients (~60%) are diagnosed after the disease has spread. The 5-year survival rate for patients with advanced disease is only around 4%. However, if detected early, the 5-year survival rate is much higher (55%-75%) with many of these being cured.
5. The National Lung Cancer Screening Trial (NLST) showed that a baseline LDCT screen followed by two annual screens, in contrast to standard lung x-rays, reduced lung cancer mortality by 20% and overall mortality by 7% over a 6 year follow-up period in individuals at high-risk for developing lung cancer.
6. Based on the NLST trial, the US Preventive Services Task Force (USPSTF) and many professional societies have recommended annual LDCT screening for individuals at high risk. 
7. There are a number of ongoing trials evaluating value of LDCT screening for reducing lung cancer mortality in high risk subjects. These include the Dutch Belgian randomized lung cancer screening trial (NELSON) and the United Kingdom Lung Cancer Screening (UKLS) trial. 
8. The IASLC acknowledges that for implementation of LDCT screening worldwide each national health service has the opportunity to decide its own course of action regarding the usefulness of CT screening based on their interpretation of the existing data from lung cancer screening trials. The implementation of any screening program should incorporate a multidisciplinary group of experts and the best practice for excellence in screening care. 
9. In the US many private health insurance companies cover screening now and starting in January 2015 all will, under provisions of the Affordable Care Act. A decision was be made November 10th, by CMS in a draft proposal to cover low-dose CT screenings for high risk individuals. 
10.  Currently, advances are being made in identifying high risk individuals with computer models using patient characteristics. Furthermore computer models are evaluating the nodule characteristics on the CT images to better define cancer potential. Likewise a range of biomarkers are being evaluated in conjunction with or independent of LDCT screening in order to detect cancer early.

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