Early lung cancer testing could save lives

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http://www.sptimes.com/2006/07/03/Citru ... _tes.shtml

By Dr. V. Upender Rao

Published July 3, 2006

The Lung Cancer Alliance commissioned a nationwide survey, which revealed that "Americans are uninformed of their options of early lung cancer testing." In response, the alliance called for more public awareness programs and increased research funding for the development of new methods of early detection.

Lung cancer is responsible for 28 percent of all cancer deaths in the United States each year. This is greater than deaths from prostate, breast, colon, liver and kidney cancers and melanoma combined.

Early detection could save more patients. However, because of a lack of awareness, 70 percent of lung cancers are detected in the late (incurable) stages. The Lung Cancer Alliance states that the five-year survival for lung cancer is only 15 percent, compared with a five-year survival of 95 percent for prostate cancer, 87 percent for breast cancer and 64 percent for colon cancer.

Lorie Fenton, president of the alliance, says that even if all smokers quit smoking today, lung cancer would be the leading cause of cancer-related deaths for decades to come because of the long latent periods between exposure to cigarette smoke and the occurrence of cancer.

Many Americans think that lung cancer strikes only men who are smokers, but 60 percent of all new lung cancer cases are diagnosed in those who never smoked and former smokers. Almost 70 percent of these patients are women.

Participants in the alliance survey also said that cigarette smoking is the only cause of lung cancer, although lung cancer among nonsmokers actually is emerging as a separate entity. Other carcinogens, co-carcinogens and genetic susceptibility are thought to be responsible for this.

Only 9 percent of women and 23 percent of men have taken steps toward testing for early detection of lung cancer, the survey found. Cumulatively, only 37 percent of Americans had done so. Keys to getting a screening program started depend upon patients and advocacy groups.

Physicians face difficulty motivating patients to quite smoking and undergo screening. We also face major obstacles in addressing economic issues related to screening. Most insurance companies do not consider lung cancer screening to be cost-effective and therefore do not provide coverage. All this despite the fact that 28 percent of all cancer-related deaths are attributable to lung cancer, many of which could be avoided by early detection.

Non-cost-effectiveness is an economical issue that can be changed. It cannot and should not be equated to medical non-necessity.

Recent medical research and literature show better survival with early detection and treatment with surgery and chemotherapy.

These facts and the awareness of the ill effects of cigarette smoking in terms of loss of life and suffering should bring about major changes in government policy regarding prevention and treatment of lung cancer.

V. Upender Rao, MD, FACP, practices at the Cancer and Blood Disease Center in Lecanto.

[Last modified July 3, 2006, 08:44:25]