Rethinking Lung Cancer Screening: Targeting High-Risk Groups
Lung cancer is a serious illness that affects a lot of people worldwide. Unfortunately, lung cancer is still diagnosed too late, when most people don’t have a very good chance of getting better. This is really concerning, and it means we need to find better ways of catching lung cancer early.
One promising way of finding lung cancer early is by doing a type of X-ray scan called a low-dose CT scan which reduces the exposure to radiation compared with traditional techniques . A study in the US showed that doing this type of scan can reduce the number of people who die from lung cancer by 20% if they’re over 55 and heavy smokers. This was really important, making low-dose CT scans a valuable tool in fighting lung cancer.
In the early stages of lung cancer, symptoms may be minimal or non-existent.
As the disease progresses, symptoms such as a persistent cough, chest pain, shortness of breath, and weight loss may develop. In advanced stages, the cancer may also spread to other parts of the body, such as the brain, bones, or liver, causing additional symptoms.
The current screening selections target people who are at a higher risk of getting lung cancer (heavy smokers over 50 years old) instead of doing CT scans for everyone. This is to reduce the number of people exposed to radiation and prevent people from getting false results, as there is always a small percentage of error in the diagnostics process. This guidelines however are missing a big part of the population who might benefit from the screening.
A recent study published in JAMA Oncology (2022) evaluated risk of lung cancer among 5888 smokers for whom annual screening with low-dose CT scan was not recommended and would therefore not get screening in normal condition. The study concluded that there is a high risk of lung cancer among smokers who do not meet the current guidelines for LDCT screening, and that new prediction models are needed to identify high-risk subsets of these smokers for screening.
One way to target people who are at a higher risk of getting lung cancer is by using more accurate ways to identify them. For example, we can use information from people’s medical records and special markers in their blood or other body fluids to find out who is more likely to get lung cancer. This will make sure that we use our resources wisely and make do not overexpose people to the CT scan radiation
Other problems of the lung cancer screening criteria
References to this information:
Early diagnosis of lung cancer in people most at risk. Br J Gen Pract . 2020 Nov 26;70(701):572-573. doi: 10.3399/bjgp20X713537.
Assessment of Lung Cancer Risk Among Smokers for Whom Annual Screening Is Not Recommended. JAMA Oncol. 2022;8(10):1428-1437.