Early Detection and Chemoprevention of Lung Cancer

Despite advances in targeted treatments, lung cancer remains a common and deadly malignancy, in part owing to its typical late presentation. Recent developments in lung cancer screening and ongoing efforts aimed at early detection, treatment, and prevention are promising areas to impact the mortality from lung cancer. In the past several years, lung cancer screening with low-dose chest computed tomography (CT) was shown to have mortality benefit, and lung cancer screening programs have been implemented in some clinical settings. Biomarkers for screening, diagnosis, and monitoring of response to therapy are under development. Prevention efforts aimed at smoking cessation are as crucial as ever, and there have been encouraging findings in recent clinical trials of lung cancer chemoprevention. Here we review advancements in the field of lung cancer prevention and early malignancy and discuss future directions that we believe will result in a reduction in the mortality from lung cancer.

Download Full-text

Serum Metabolite Profiles in Participants of Lung Cancer Screening Study; Comparison of Two Independent Cohorts

Cancers ◽

10.3390/cancers13112714 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2714

Author(s):

Piotr Widłak ◽

Karol Jelonek ◽

Agata Kurczyk ◽

Joanna Żyła ◽

Magdalena Sitkiewicz ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Early Detection ◽

Cancer Patients ◽

Pulmonary Nodules ◽

Lung Cancer Screening ◽

Lung Cancer Patients ◽

Screening Programs ◽

N 93 ◽

Promising Source

Serum metabolome is a promising source of molecular biomarkers that could support early detection of lung cancer in screening programs based on low-dose computed tomography. Several panels of metabolites that differentiate lung cancer patients and healthy individuals were reported, yet none of them were validated in the population at high-risk of developing cancer. Here we analyzed serum metabolome profiles in participants of two lung cancer screening studies: MOLTEST-BIS (Poland, n = 369) and SMAC-1 (Italy, n = 93). Three groups of screening participants were included: lung cancer patients, individuals with benign pulmonary nodules, and those without any lung alterations. Concentrations of about 400 metabolites (lipids, amino acids, and biogenic amines) were measured by a mass spectrometry-based approach. We observed a reduced level of lipids, in particular cholesteryl esters, in sera of cancer patients from both studies. Despite several specific compounds showing significant differences between cancer patients and healthy controls within each study, only a few cancer-related features were common when both cohorts were compared, which included a reduced concentration of lysophosphatidylcholine LPC (18:0). Moreover, serum metabolome profiles in both noncancer groups were similar, and differences between cancer patients and both groups of healthy participants were comparable. Large heterogeneity in levels of specific metabolites was observed, both within and between cohorts, which markedly impaired the accuracy of classification models: The overall AUC values of three-state classifiers were 0.60 and 0.51 for the test (MOLTEST) and validation (SMAC) cohorts, respectively. Therefore, a hypothetical metabolite-based biomarker for early detection of lung cancer would require adjustment to lifestyle-related confounding factors that putatively affect the composition of serum metabolome.

Download Full-text

Faculty Opinions recommendation of Evaluations of Implementation at Early-Adopting Lung Cancer Screening Programs: Lessons Learned.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727331461.793541141 ◽

2018 ◽

Author(s):

Robert Keith ◽

Melissa New

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Lessons Learned ◽

Screening Programs

Download Full-text

Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djab002 ◽

2021 ◽

Cited By ~ 1

Author(s):

Christopher J Cadham ◽

Pianpian Cao ◽

Jinani Jayasekera ◽

Kathryn L Taylor ◽

David T Levy ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cost Effectiveness ◽

Cancer Screening ◽

Task Force ◽

Lung Cancer Screening ◽

Cancer Registries ◽

Web Based ◽

Screening Programs ◽

Life Years

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.

Download Full-text

Updates and Controversies in the Rapidly Evolving Field of Lung Cancer Screening, Early Detection, and Chemoprevention

Cancers ◽

10.3390/cancers6021157 ◽

2014 ◽

Vol 6 (2) ◽

pp. 1157-1179 ◽

Cited By ~ 16

Author(s):

Hasmeena Kathuria ◽

Yaron Gesthalter ◽

Avrum Spira ◽

Jerome Brody ◽

Katrina Steiling

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Early Detection ◽

Lung Cancer Screening

Download Full-text

P2.11-21 Factors Predicting Attrition in Community-Based Healthcare Network Lung Cancer Screening Programs

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.1368 ◽

2018 ◽

Vol 13 (10) ◽

pp. S786-S787

Author(s):

K. Spiegel ◽

J. Rayburn ◽

C. Wilshire ◽

E. Rauch ◽

J. Handy ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Community Based ◽

Screening Programs ◽

Healthcare Network

Download Full-text

Assessing Lung Cancer Screening Programs under Uncertainty in a Heterogeneous Population

Value in Health ◽

10.1016/j.jval.2018.01.021 ◽

2018 ◽

Vol 21 (11) ◽

pp. 1269-1277 ◽

Cited By ~ 1

Author(s):

Henk Broekhuizen ◽

Catharina G.M. Groothuis-Oudshoorn ◽

Rozemarijn Vliegenthart ◽

Harry J.M. Groen ◽

Maarten J. IJzerman

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Heterogeneous Population ◽

Screening Programs

Download Full-text

Smoking Cessation and Lung Cancer Screening Programs: The Rationale and Method to Integration

Lung Imaging and CADx ◽

10.1201/9780429055959-10 ◽

2019 ◽

pp. 225-242

Author(s):

Meghan Cahill ◽

Brooke Crawford O'Neill ◽

Kimberly Del Mauro ◽

Courtney Yeager ◽

Bradley B. Pua

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Screening ◽

Lung Cancer Screening ◽

Screening Programs

Download Full-text

Early detection system using low-dose CT lung cancer screening and related SNP information

Medical Imaging 2021: Computer-Aided Diagnosis ◽

10.1117/12.2582092 ◽

2021 ◽

Author(s):

Yuta Azuma ◽

Yoshiki Kawata ◽

Noboru Niki ◽

Issei Imoto ◽

Masahiko Kusumoto ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Early Detection ◽

Low Dose ◽

Detection System ◽

Lung Cancer Screening ◽

Low Dose Ct

Download Full-text

Lung Cancer Screening: Promise and Pitfalls

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2012.32.35 ◽

2012 ◽

pp. 450-457

Author(s):

Christine D. Berg ◽

Denise R. Aberle ◽

Douglas E. Wood

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Cancer Mortality ◽

Lung Cancer Screening ◽

Lung Cancer Mortality ◽

Medical Community ◽

Helical Computed Tomography ◽

Screening Guidelines ◽

Screening Programs ◽

National Lung Screening Trial

OVERVIEW: The results of the National Lung Screening Trial (NLST) have provided the medical community and American public with considerable optimism about the potential to reduce lung cancer mortality with imaging-based screening. Designed as a randomized trial, the NLST has provided the first evidence of screening benefit by showing a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality with low dose helical computed tomography (LDCT) screening relative to chest X-ray. The major harms of LDCT screening include the potential for radiation-induced carcinogenesis; high false-positivity rates in individuals without lung cancer, and overdiagnosis. Following the results of the NLST, the National Comprehensive Cancer Network (NCCN) published the first of multiple lung cancer screening guidelines under development by major medical organizations. These recommendations amalgamated screening cohorts, practices, interpretations, and diagnostic follow-up based on the NLST and other published studies to provide guidance for the implementation of LDCT screening. There are major areas of opportunity to optimize implementation. These include standardizing practices in the screening setting, optimizing risk profiles for screening and for managing diagnostic evaluation in individuals with indeterminate nodules, developing interdisciplinary screening programs in conjunction with smoking cessation, and approaching all stakeholders systematically to ensure the broadest education and dissemination of screening benefits relative to risks. The incorporation of validated biomarkers of risk and preclinical lung cancer can substantially enhance the effectiveness screening programs.

Download Full-text