Lung cancer screening and early detection can increase curability and save lives!

Lung cancer screening and early detection can increase curability and save lives!

Murry W. Wynes, PhD
IASLC Special Projects Manager

Rob Mansheim
IASLC Director of Communications
(720) 325-2952



Lung cancer screening and early detection can increase curability and save lives!

DENVER – November is Lung Cancer Awareness Month and the International Association for the Study of Lung Cancer (IASLC) is the only global organization solely dedicated to the study of lung cancer and is committed to conquer thoracic malignancies worldwide. Lung cancer is a devastating disease with 1.6 million people diagnosed globally (US 225,000) each year which results in 1.4 million deaths (US 160,000). Lung cancer is the leading cause of cancer-related deaths in both men and women in many countries throughout the world. The majority of cases (~60%) are diagnosed after the disease has spread to distant areas and the 5-year survival rate for those with advanced disease is only around 4%. However, if detected early, when the tumor is still localized, the 5-year survival rate is much higher at 55%-75% with many of these being cured.

The National Lung Cancer Screening Trial (NLST) showed that a low-dose computed tomography (LDCT) screen followed by two annual screens, compared to standard lung x-ray screening, reduced the lung cancer mortality by 20% and overall mortality by 7% over a 6 year follow-up period in individuals at high-risk for developing lung cancer. “Our society has clearly demonstrated the importance of stage determination at diagnosis as a reliable indicator of clinical outcome and with the recommendation of the United States Preventive Services Task Force (USPSTF) we now, for the first time, have a validated tool to more reliably find Stage I curable lung cancer in asymptomatic high risk populations. This is a profound opportunity for improving outcomes for this tragically lethal cancer” says Dr. James L. Mulshine, member of IASLC and Professor and Associate Dean at Rush University, Chicago, Illinois.

Based on the NLST trial, the USPSTF has recommended annual LDCT screening for individuals between the ages of 55-80 years with an extensive cigarette smoking history, greater than or equal to 30 pack-years, including former smokers who quit within the past 15 years. Professional societies like American Cancer Society, American College of Chest Physicians, American Medical Association, American College of Radiology, and American Society of Clinical Oncologists have made similar recommendations.

The IASLC organized a CT screening workshop that consisted of multidisciplinary clinical experts from around the globe to review the findings of the NLST study. The IASLC acknowledges that for implementation of LDCT screening worldwide each national health service has the opportunity to decide its own course of action regarding the usefulness of CT screening based on their interpretation of the existing data from lung cancer screening trials. The implementation of any screening program should incorporate a multidisciplinary group of experts and the best practice for excellence in screening care. Also, during the course of creating and implementing recommendations for screening professional societies, organizations, national health systems, and other stakeholders should focus on

  1. Identification of high-risk individuals.
  2. Developing radiological guidelines, definitions for positive versus negative results.
  3. Developing guidelines for the clinical work-up of “indeterminate nodules”.
  4. Guidelines for pathology reporting of nodules.
  5. Recommendations for surgical and therapeutic interventions of suspicious nodules.
  6. Integration of smoking cessation into national lung cancer CT screening programs.

In the US, many private health insurance companies do cover this procedure now and all will have to start in January 2015 under provisions of the Affordable Care Act. A decision in November will be made regarding insurance coverage of lung cancer screening in the US for individuals covered by Federal insurance.

There are a number of ongoing trials in the field of lung cancer screening. The Dutch Belgian randomized lung cancer screening trial (NELSON) and the United Kingdom Lung Cancer Screening (UKLS) trial are in principal similar to the NLST; they are evaluating the value of LDCT screening for reducing lung cancer mortality in high risk subjects. The NELSON trial is planning to report in 2015 and then pooling with the UKLS in 2016, which will provide mortality and cost effectiveness data within Europe. The NELSON trial has already provided evidence for the utility of volumetric analysis of CT detected nodules, which would reduce the number of false positives.

Currently, advances are being made in identifying the high risk individuals with computer models using patient characteristics. Furthermore computer models are evaluating the nodule characteristics on the CT images to better define cancer potential. Likewise a range of biomarkers are being evaluated in conjunction with or independent of LDCT screening in order to detect cancer early.

“With the implementation of LDCT programs around the globe, we are upon new challenges, among high volume of patients with solitary pulmonary lung nodules on their CT scans”, says Professor Nir Peled from Tel-Aviv University, the Chair of the IASLC Screening and Early Detection Committee. “Non-invasive biomarkers may avoid unnecessary invasive investigations and enhance proactive therapy. This avenue is being assessed in longitudinal studies and worth a significant focus in the coming years.”

“We have now entered a new era for early lung cancer detection, each country needs to assimilate the current and forthcoming data, and seriously consider the feasibility of implementing lung cancer CT screening” says Professor John K. Field, Chair IASLC Strategic Screening Advisory Committee and Professor at the University of Liverpool, UK.

The potential for saving lives through lung cancer CT screening will dramatically change the disease statistics in the coming years. The emergence of screening in the US and the eagerly awaited results from the European trials will provide a new era for lung cancer early detection. 

For more information on Lung Cancer Awareness and IASLC please visit us at



About the IASLC:

The International Association for the Study of Lung Cancer (IASLC) is the only global organization dedicated to the study of lung cancer. Founded in 1974, the association’s membership includes more than 4,000 lung cancer specialists in 80 countries. To learn more about IASLC please visit