Routine lung cancer screening for smokers saves lives

This blog is written by our clinicians and aims to keep patients informed with up to date information on medical conditions. The editor of the blog is Dr Cristina Romete.

Lung cancer is the third most common cancer in the UK and smoking accounts for over 85% of cases.1

Three quarters of those diagnosed with lung cancer will receive the devastating diagnosis at a late stage of their disease, meaning it is harder to treat and unlikely to be cured.

The stage of a cancer tells you how big it is and whether it has spread. Stages include I, II, III and IV, with I being the smallest and no spread to IV being the biggest with spread.

Diagnosis at a later stage of lung cancer is unfortunately very common in younger adults (aged 15-59) in England (81% diagnosed at stage III or IV) and is slightly more so than older adults aged 60-79 (76% diagnosed at stage III or IV).1

 

Is it possible to screen for lung cancer?

The evidence from two large trials (NLST and more recently NELSON) has concluded that yes, screening for lung cancer is not only possible but it increases the chances of catching lung cancer early and as a result it positively increases the chances of cure.

 

The NELSON trial

NELSON is a randomized, controlled, population-based screening trial for which individuals from population-based registries in the Netherlands and Belgium were recruited.

It looked at 16,000 people, namely men and women aged 50 to 74 years with a smoking history of more than 10 cigarettes a day for more than 30 years or more than 15 cigarettes a day for more than 25 years.

Slightly more than half of the participants were current smokers. Roughly 45% of participants had quit in the past 10 years, although they still met the requisite number of pack-years for study entry.

 

NELSON study findings

The findings were quite conclusive in showing that, at year 10, screening reduced death from lung cancer by 26% for men and 39% for women.

50% of lung cancers detected during the screening program were very-early-stage (IA) cancers; 69% of screen-detected lung cancers were of stage IA or B.2

Only 10% to 12% of those in the screening arm were diagnosed with stage IV disease2 which is considerably lower than the current percentage of 76%-81% of UK lung cancers caught at stage IV.

 

We recommend lung cancer screening

At ROC Private Clinic we recommend lung cancer screening using low dose CT chest for people with a heavy smoking history of 30 pack years or more.

 

Calculating ‘pack years’ of smoking

You can calculate the pack years of smoking by multiplying the number of packs smoked per day by the number of years you’ve smoked.

For example, if you smoked 2 packs of cigarettes a day for 15 years, that’s 30 pack years. If you smoked half a pack of cigarettes a day for 30 years, that’s 15 pack years.

Get in contact with us at ROC if you have any questions about lung screening, smoking cessation or any other issues raised in this post.

 

References:

  1. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/incidence#heading-Three (accessed 23/10/18)
  2. https://www.medscape.com/viewarticle/902673#vp_2 (accessed 23/10/18)

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