Decreased lung cancer death rates linked to earlier diagnosis

Early detection and increased reliance on lung cancer screening saves lives, according to a study released Friday.
Patients using CT scans and monitoring for potential cancers help doctors identify the growth of precancerous and early tissue for surgical removal, leading to lower lung cancer deaths, Mount Sinai Health System researchers report in an article published on JAMA Network Open.
The nonprofit health system team has embarked on one of the largest population-based studies on the links between lung cancer screenings and survival rates, said Dr Raja Flores, lead author of the study and chair of thoracic surgery at Mount Sinai Health System. At New York. The results mirror those of the National Cancer Institute’s 2011 national lung screening trial, he said.

“What we have to realize is that we have a cure for lung cancer: it’s called surgery,” Flores said. “The problem is, we don’t find it soon enough.”

Although some drugs have been shown to prolong survival, the only way to cure lung cancer is to “catch it early and get it out,” Flores said.

Researchers from Mount Sinai determined that lung cancer deaths declined an average of 4% per year from 2006 to 2016 by analyzing data from the National Cancer Institute’s Surveillance, Epidemiology and Final Outcomes Program on 312,382 patients with non-small cell lung cancer.

During those 10 years, early stage diagnoses increased significantly from 26.5% to 31.2% and late stage diagnoses increased from 70.8% to 66.1%. Patients who were determined to have early-stage lung cancer had a median survival time of almost five years, while the median for advanced cancer was seven months.

The U.S. Prevention Services Task Force recommended in 2013 that people at risk for lung cancer undergo CT scans every year. These tests typically detect cancer in 24.2% of screenings, while chest x-rays only detect cancer in 6.9% of cases.

Despite this, only about 5% of patients who meet the criteria are tested, said Dr. Emanuela Taioli, study author and associate director of Population Science at the Mount Sinai Tisch Cancer Institute, in a press release.

Nationally, lung cancer is one of the leading causes of cancer death and is diagnosed in more than 200,000 people each year.

The findings from Mount Sinai underscore the need for those at risk of screening and for health systems to consider broader eligibility standards, said Dr Claudia Henschke, professor of diagnostic, molecular and interventional radiology at Icahn School of Medicine at Mount Sinai, in a press release. .

“If everyone eligible for screening received the low-dose CT scan, which has a radiation dose comparable to an annual mammogram, we could save up to 80% of those people,” Henschke said. “Our lung cancer screening program is open to anyone at risk of lung cancer, to anyone aged 40 and over, whether they have never smoked, smoked or have been a former smoker.”

Doctors need to help patients understand that if they are caught early, their chances of recovery are four in five, Flores said.

Previous studies have also explored historical links between non-small cell lung cancer mortality and programs to help individuals quit smoking, as well as earlier interventions and targeted therapies.

Wolfgang Lehner of Brooklyn, New York, received multiple screenings and his early diagnosis was fluke that led to his lung cancer survival, he said.

Lehner, 62, started smoking at 15 in his native Austria and quit 35 years later in 2010.

Due to his symptoms, age and smoking history, doctors at Mount Sinai recommended Lehner see a lung specialist and have a biopsy. When the results revealed a slowly growing adenocarcinoma, Lehner felt lucky to have caught the cancer early on, he said. Less than a month later, he had the growth removed.

“People sometimes don’t want to know if they are sick or not because it could get very expensive with the health insurance situation,” Lehner said. “People should get over their fears and get tested.”

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