Risk assessment of lung cancer in high-risk patients

Most lung cancers are diagnosed once they are at a late stage1

  • Lung cancer tends to be diagnosed when symptoms become apparent; by this time the tumour is often at an advanced stage (III or IV).
  • Over 50% of all patients die within 12 months of diagnosis.
  • Early diagnosis more than triples the 5-year survival rate to 56% if the tumour is found to be localised, but unfortunately, only 16% of lung cancer are diagnosed while still localised.

1 Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.

Diagnosing lung cancer early saves lives

  • Annual computed tomography (CT) screening of high-risk patients is associated with a 20% reduction in lung cancer mortality thanks to early-stage detection.3
  • CT screening is only available in the US and for patients at very high risk of lung cancer.4
  • The high-risk criteria for eligibility for CT screening mean that only 30% of lung cancers are caught;
  • 70% of lung cancers occur in patients who are not eligible for screening under US guidelines.5
  • CT screening produces 96% false positives.6

3 The National Lung Screening Trial Research Team.  Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. N Engl J Med 2011; 365:395-409.
4 Final Update Summary: Lung Cancer: Screening. U.S. Preventive Services Task Force. July 2015. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening
5 Pinsky P. & Berg C., Applying the National Lung Screening Trial eligibility criteria to the US population: what percent of the population and of incident lung cancers would be covered. J Med Screen 2012; 19:154-156
6 The National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365:395-409.

EarlyCDT—Lung test can detect lung cancer-associated autoantibodies 4 years or more before diagnosis. 7,8

  • Screening with EarlyCDT—Lung complements CT scanning.
  • EarlyCDT—Lung can be used to qualify patients at lower risk thresholds (relative to the NLST criteria) for annual CT screening.
  • Where CT screening is not available, use EarlyCDT—Lung with patients at increased risk of lung cancer, then follow-up positive results with serial CT scans.
 
  • The National Health Service (NHS) in Scotland is investigating this use in the world’s largest randomised clinical trial for the early detection of lung cancer using biomarkers in the blood.
  • The NHS study is demonstrating a significant diagnostic stage shift compared to normal UK clinical practice: 75% of all cancers found (n=16) have been at stage I or II; in normal practice 80% of cancers are diagnosed at stage III or IV. The NHS results thus reflect a 55% stage shift.
 

7 Zhong L, et al. Profiling Tumour-Associated Antibodies for detection of Non-small Cell Lung Cancer. J Thor Oncol 2006; 1:513-519.
8Jett J, et al. Determination of the detection lead time for autoantibody biomarkers in early stage lung cancer using the UKCTOCS cohort. J Thor Oncol 2017; 12(11):S2170

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