While screening programs for several of the commonest cancers are now well established – like breast or colon cancer for example – lung cancer screening has yet to reach anywhere near the same proportion of at-risk patients. A recent report by the American Lung Association concluded that in 2021 less than 6% of eligible Americans were screened for lung cancer . This low screening rate is almost certainly a contributor to the fact that lung cancer stubbornly remains the world’s leading cause of cancer death. And the numbers are high. Lung cancer is second only to breast cancer in terms of the number of new cases each year.
The arguments against the effectiveness of lung cancer screening go back more than 30 years, among them the belief that the high number of false positives generated would lead to overdiagnosis, resulting in unnecessary patient anxiety and invasive procedures; that annual screening would exceed a patient’s recommended cumulative radiation dose; and that it would stigmatize smokers – one of the highest risk target groups.
“The first thing we need to do to improve lung cancer screening rates is to encourage greater participation in those screening programs that do exist, through better education and outreach, increased clinician referrals, improved accessibility, and wider reimbursement. For example, in partnership with Roswell Park Comprehensive Cancer Center in Buffalo, NY, Philips and Roswell Park are expanding access to early lung cancer screening via Project EDDY (Early Detection Driven to You), bringing mobile low dose CT lung cancer screening to at-risk populations of medically underserved and racially diverse populations in rural and metro areas of New York.” – Dr. Ilya Gipp, MD, PhD, Chief Medical Officer Oncology, Precision Diagnosis at Philips
“The second thing is to improve our eligibility criteria, which at present are largely based on just two simple parameters – age and smoking history. But it isn’t just high ‘pack-year’ smokers who are at increased risk of getting lung cancer. All sorts of professions, from firefighters and asbestos workers to military personnel and welders are, or have been exposed, to lung cancer causing carcinogens. As clinicians, we surely owe them all the same duty of care.” – Dr. Ilya Gipp