Opinion: Scaling up early detection is vital to reduce lung cancer mortality

Lung cancer is the leading cause of cancer death worldwide, accounting for an estimated 2.5 million diagnoses and 1.9 million deaths in 2022. Low- and middle-income countries, or LMICs, bear the greatest burden, representing about 70% of global lung cancer deaths. This is largely because nearly 80% of lung cancers are detected at an advanced stage (stage III or IV) in LMICs.

The demographics of lung cancer also differ by region and ethnicity. In Asian populations, for example, there is a higher rate of a specific form of lung cancer mutation called epidermal growth factor receptor compared to Caucasians. In addition, there is a higher prevalence of diagnosed patients who are typically young, female, and never-smokers in Asia. Moreover, there is an increasing incidence of lung cancer in never-smokers, or LCINS. In fact, LCINS, on its own, was the fifth most common cause of cancer-related deaths worldwide in 2023.

Several studies, for example the U.S.-based National Lung Screening Trial, or NLST, the U.K. Manchester Lung Health Check study, and the Dutch-Belgian NELSON study, have evidenced that lung cancer screening using low-dose computed tomography, or LDCT, can reduce lung cancer mortality. However, despite this, lung cancer is not being prioritized within national cancer control programs. Very few geographies have implemented early screening for high-risk individuals — and, when they do, they typically target current or former smokers despite an increasing incidence of cancer in never-smokers. In others, there are concerns about cost and health-system readiness.

To change this, increase survival rates, and improve outcomes, global barriers limiting progress in lung cancer screening programs and outcomes must be tackled.

The Saving Lives from Lung Cancer Platform

The Saving Lives from Lung Cancer Platform aims to support action from policymakers and those working across global health care to prioritize earlier detection, diagnosis, and treatment of lung cancer and mobilize advocacy to spur screening guidelines into action. The methodology informing the platform, map and calculator was developed with feedback and insights from members of the Lung Cancer Policy Network (see Disclaimer i).

Currently including seven geographies — Argentina, Brazil, Colombia, Mexico, Singapore, Taiwan, and Thailand — the global platform has analyzed a wide range of lung cancer data. Projections suggest that implementing early lung cancer screening programs and ensuring timely intervention of treatment could save more than 20,600 additional lives (see Disclaimer ii) and increase the five-year survival rate of patients by 73% (see Disclaimer iii) in the first year of implementation across the geographies studied.

Interactive platform provides pathway for improved lung cancer outcomes

The Saving Lives from Lung Cancer Platform also provides insights into how we, as a global community, can help drive improved lung cancer outcomes in LMICs through a resource-stratified approach.

We need to work together to improve equitable access to lung cancer screening worldwide. This requires supporting ground-breaking collaborations and fast-tracked innovation to address the needs of the global lung cancer community. For example, artificial intelligence-assisted chest X-rays — which use AI algorithms to interpret radiology images — may be a resource-optimizing approach to integrate with LDCT screening programs to identify patients with suspicious radiographic lung markers and support their referral to arrive at a firm diagnosis.

Now is the time to eliminate lung cancer as a leading cause of death

The Saving Lives from Lung Cancer Platform is working to support policymakers, health care providers, advocates, and politicians to identify high-risk populations beyond smokers and campaign for early lung cancer intervention. By building momentum and sustaining the conversation around the opportunity to save more lives from lung cancer, we can work together to improve health outcomes for lung cancer patients and reduce mortality from lung cancer, the leading cause of cancer deaths.

Author’s note:

Disclaimer i: The Saving Lives from Lung Cancer Platform was created by Inizio Evoke and Speyside, which received funding from AstraZeneca for this work. The Lung Cancer Policy Network was invited to provide feedback on the methodology for the map and calculator. The Global Saving Lives from Lung Cancer Map & Calculator can be accessed through the resource library on the Lung Cancer Policy Network's website.

Disclaimer ii: Data point obtained from averaging number of potential lives that could be saved in the first year across the seven international geographies and six screening scenarios included in The Global Saving Lives from Lung Cancer Map & Calculator.

Disclaimer iii: Data point obtained from averaging the potential five-year survival rate (%) increase in the first year across the seven international geographies and six screening scenarios included in The Global Saving Lives from Lung Cancer Map & Calculator.

Visit our website for more information about The Saving Lives from Lung Cancer Platform and to learn more about the potential to address the needs of the global lung cancer community through The Global Saving Lives from Lung Cancer Map & Calculator: https://www.lungcancerlivessaved.com/