Low dose CT (LDCT) screening for lung cancer is not just for smokers. It can also be used to successfully screen patients who have never smoked for the disease.
During the 2021 International Association for the Study of Lung Cancer World Conference this weekend, researchers from Taiwan revealed data showing that LDCT screening can identify the presence of lung cancer in individuals who have not smoked regularly. active, but still at high risk for the disease.
Existing studies, including the National Lung Screening Test (NLCST) and NELSON Trial have already revealed the role of LDCT in smokers, but with 10 percent to 15 percent of cases Lung cancer develops in non-smokers, able to detect disease in this vital group.
Because lung cancer is Taiwan’s leading cause of cancer mortality – and 53 percent of people who die have never smoked – researchers, led by Pan Chyr Yang, MD, Ph.D., high Distinguished professor from Taiwan National College of Medicine with special interest in lung cancer genomics, launched Taiwan Lung Cancer Screening for Non-Smoking Testing (TALENT). This study not only tested the effectiveness of LDCT with non-smokers, but its goal is to create an effective screening strategy and risk prediction model for high-risk people. identify who would benefit from screening.
“The study showed that LDCT screening for lung cancer in non-smokers may be at high risk, which is very important for all those fighting lung cancer, [considering] the growing global risk of lung cancer in smokers, ”he said. “More importantly, the study showed that a family history of lung cancer may increase your risk of lung cancer.”
For the study, Yang’s team enrolled 12,011 participants who had at least one lung cancer risk factor, including family history within tertiary relationships, exposure to passive smoking, tuberculosis or lung disease obstruction, cooking index of 110 or more, and without ventilation at cooking time. Patients, aged between 55 and 75, were enrolled between February 2015 and July 2019.
Of the participants, Yang said, 6,009 (50 percent) had a family history of lung cancer. Based on screening, 2,094 (17.4 percent) were considered positive, resulting in 395 (3.3 percent) lung biopsies or surgeries. In total, 313 patients (2.6 per cent) received lung cancer diagnoses – 255 (2.1 per cent) had an invasive disease. Almost all diagnoses – 96.5 percent – were for stage 1 disease, and adenocarcinoma was all but one. Disorded lung disease or other type of cancer accounted for the remaining 81 patients.
According to their findings, the incidence of lung cancer was 3.2 percent and 2.0 percent in patients with and without a family history of lung cancer, respectively. In addition, the incidence of invasive lung cancer was 2.6 percent and 1.6 percent, respectively, and the risk was increased by the number of first-degree relatives with lung cancer who had a patient:
- 0: 2.0 percent
- 1: 3.1 percent
- 2: 4.0 percent
- 3: 6.7 percent
- 4: 9.1 percent
Those decisions, Yang said, were encouraging.
“Most importantly, 96.5 per cent [of] patients were at level 0 or 1, [and] they could be treated with surgery, ”he explained. “Our study also showed the high risk in family history, especially those [participants] with a family history of early stage lung cancer. ”
Using these results, he said his team is working to create a risk score predictor that incorporates family history, as well as genetic and environmental factors, to identify high-risk, non-smoking patients. could benefit from LDCT screening.
“We hope that the screening program will benefit patients with lung cancer, especially in those countries with high lung cancer without ever smoking,” he said.
Ultimately, he said, that work should lead to a nationwide screening protocol that can be implemented.
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