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Lung Cancer Survival High for Patients With Early, Screen-Detected Tumors

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RSNA

— Two decades of I-ELCAP follow-up data show 80% lung cancer-specific survival rate

By
MedPage Today contributor Ed Susman
November 28, 2022

CHICAGO — Low-dose CT (LDCT), which was used to diagnose early-stage lung cancer, led to high rates for lung cancer-specific survival 20 years later, according I-ELCAP data.

Claudia Henschke, MD and PhD of Mount Sinai Icahn Schools of Medicine in New York City reported that the 20-year survival rate for lung cancer was 80% among 1,285 IELCAP participants with early-stage disease. This was at the Radiological Society of North America’s (RSNA) annual meeting.

She The 100% survival rate for lung cancer was reported for the 139 participants who had non-solid, cancerous nodules in their lungs and for the 155 patients who had nodules of part solid consistency. A 73% rate was reported for the 991 participants who had solid nodules.

The estimated lung cancer-specific survival for clinical stage IA lung cancers, and for resected pathologic stage IA lung cancers measuring ≤10 mm in average diameter of length and width on the same CT image, was 86%, regardless of consistency. For participants with pathologic stage IA cancers of ≤10 mm, the 20-year lung cancer-specific survival rate was 92%, Henschke stated.

The current study expands upon findings from 2006 when I-ELCAP researchers discovered a 10-year survival rate for lung cancer in early-stage disease.

MedPage Today was informed by Henschke that lung cancer screening is now considered life-saving therapy. However, only about 15% of those who are eligible for screening are currently being screened. She The radiation dose required to screen for lung cancer in people is only 10% of that used in most mammograms.

She said, “We have made some progress in screening, as at the beginning of this, there wasn’t any screening at all.” “But, we still have a lot to do.”

Henschke said that there are many reasons lung cancer screening hasn’t caught on with more patients or clinicians. One reason is that there is widespread belief that there is nothing one can do to stop it being detected, and that treatment is very harsh.

She said, “But we are now discovering new surgical and radiotherapy treatments that are far more invasive than major lung surgery.” “And now, we know that lung-cancer survival is possible for most patients for at least 20 years.”

Henschke indicated that she and her colleagues continue to follow patients in the IELCAP study and that they continue enrolling patients in screening protocols. “We are hopeful that our work can allow us to broaden the treatment guidelines,” she stated.

According to the American Lung Association (ALA), there is an average survival rate of 18.6% for lung cancer over five years. Less than one fifth of lung cancer cases are diagnosed in the early stages. More than half of lung cancer patients die within one year.

The U.S. Preventive Services Task Force recommends an annual LDCT screening for those aged 50-80 who have had a 20-year history of smoking and have not quit in the past 15 years. A recent study found that LDCT screening was not being used by eligible patients according to USPSTF guidelines.

Max Wintermark, MD of MD Anderson Cancer Center Houston, stated to MedPage Today, “When we discuss screening and vaccination, there is always concern over what you’re doing or if it is worthwhile.”

“It’s nice to have such data to guide [patients]…Obviously, lung cancer can be detected early in life. There are ways to treat it,” Wintermark said, not being part of the study.

In 1992, the International Early Lung Cancer Action Program (IELCAP) was established with the aim of advancing LDCT screening. More than 87,000 people have been enrolled in the multi-institution, multinational research program from more than 80 institutions.

Ed Susman, a freelance medical writer, is located in Fort Pierce, Florida USA.

Disclosures

Wintermark did not disclose any industry relationships.

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