Anyone can get lung cancer. Unfortunately, due to the lack of symptoms in the early stages, many people are diagnosed once their disease has advanced already. Screening can help detect cancer earlier, when treatments are more likely to work. That’s why getting checked is so important for anyone who is at high risk.
Dr. Barbara J. Gitlitz, practising oncologist and Senior Medical Director in Product Development Clinical Oncology from Roche, had the opportunity to speak to Ewelina Szmytke, Vice President of Lung Cancer Europe (LuCE) and lung cancer advocate for more than 15 years, about the value of screening and the importance of biomarker testing.
Dr. Barbara J. Gitlitz: Lung cancer is responsible for the most cancer-related deaths in the world. It is such a challenging disease – by the time people notice symptoms, the cancer may have already spread. Screening programmes allow physicians to look for cancer in people at high risk, even before they have any symptoms. We’ve seen great outcomes across Europe from national screening programmes for other kinds of cancer, including breast, cervical and gastrointestinal cancers. However, lung cancer screening rates are a fraction of those for breast cancer.
Ewelina Szmytke: There are some pilot lung cancer screening programmes. In Poland we had a pilot study and implemented a national low-dose CT screening programme for lung cancer. But when it comes to implementing national screening programmes for lung cancer, there does seem to be hesitation from health services because there are several challenges such as the need to have enough CT scanners available and the right infrastructure in place. The cost effectiveness of such programmes might be the main consideration for national authorities, so it’s vital that policymakers across Europe recognise that this is an urgent societal and political need.
Dr. Barbara J. Gitlitz: Yes, absolutely. We’ve seen the effectiveness of screening programmes in studies such as NELSON –the largest trial in Europe of its kind – which found a positive effect of low-dose volume CT screening in reducing lung cancer mortality rates, echoing results from the US-based National Lung Screening Trial (NLST). In this study, mortality was reduced by 24% in men and 33% in women in the treatment group compared with the unscreened control group.
Lung cancer is the leading cause of death from cancer worldwide and causes more deaths than breast, colorectal, and cervical cancers combined –cancers for which population-based screening programs exist. The reduction of breast and lung cancer-related mortality has been shown to be similar when screening is implemented.
Ewelina Szmytke: There is another challenge though, in encouraging people to take up lung cancer screening. Lung cancer is often perceived as a disease that is brought upon oneself, in a way not seen with some other cancers – for example skin cancer, where you don’t see people being blamed for not wearing sunscreen. This stigma means people are often reluctant to seek help for fear of being blamed or shamed for their illness. Education and information about early detection is so important – people need to know that so much more can be done to manage the disease if detected and treated early.
Dr. Barbara J. Gitlitz: Another important aspect of earlier diagnosis and treatment is the increasing role of biomarker testing, which can help physicians identify the right treatment for the individual patient. However, despite European guidelines recommending testing, a
Ewelina Szmytke: Raising awareness and education is vital. We need to improve physician awareness of the impact of biomarker testing through educational activities, as well as educate patients so that they can make an informed decision about their treatment. This is an area that also requires collaboration between both professional and political experts to make sure patients have access to these tests.
Dr. Barbara J. Gitlitz: LuCE does a huge amount of work to advocate for European policies that will hopefully lead to improvement in lung cancer diagnosis and treatment, as well as supporting and establishing lung cancer patient groups across Europe. At Roche, we’re incredibly proud to partner with organisations like LuCE as well as other key stakeholders, such as healthcare professionals and professional societies. These cross-discipline collaborations are really important.
Ewelina Szmytke: I think they’re crucial. LuCE is the voice of people affected by lung cancer in Europe, advocating and networking to improve outcomes for patients. The collaborations are vital to enable us to identify and address the barriers relating to lung cancer care and treatment and we hope this will support the successful implementation of national screening programmes. Together with its partners, including Roche, LuCE has been developing a range of reports tackling relevant challenges for the lung cancer patient community.
Dr. Barbara J. Gitlitz: The work you do is incredibly important. Let’s hope that our combined efforts mean more people know how important it is to get checked.
Discover more about the symptoms, diagnosis, and treatment of lung cancer.
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