The Lung Cancer Alliance (LCA) announced Feb. 25 that statistics recently released by the American Cancer Society (ACS) indicate that lung cancer continues to kill more people each year than all the other major cancers combined.

Beginning in 2003, ACS started using the 2000 census for its age adjusted statistical analysis. Since that time, the incidence rate for lung cancer in men rose from 86 new cases per every 100,000 of population to 89, and incidence rates for women went from 51.4 to 55.2.

The LCA points out that in research dollars per death, lung cancer is receiving a fraction of the amounts given to breast, prostate and colon cancers.

The five-year survival rate for breast cancer now stands at 88 percent, prostate cancer 99 percent and colon cancer 65 percent, while lung cancer remains at 15 percent.

The ACS credits screening as a major component in achieving high survival rates. So, part of the problem, according to an article published in the Baltimore Sun Feb. 27, is that there is not yet any effective way to screen for lung cancer.

Reporter Stephanie Desmon found that neither physicians nor major medical societies advocate lung cancer screening at this time, because no one has proved that it saves lives.

Studies have shown that screenings find more cancer, but also more lesions and nodules that may or may not be cancer, Desmon’s report said. This leads to confusion about how to treat these spots, or whether to treat them at all. There also are concerns that lung screenings may lead to further tests, biopsies and surgeries, some of which may be unnecessary or harmful to a patient. Scans that produce “watch and see” results also lead to fear and anxiety, and emotional cost to the patient.

In 2002, the National Cancer Institute launched the National Lung Screening Trial (NLST), which will compare two ways of detecting lung cancer – spiral computed tomography (CT) and the standard chest X-ray. By Feb. 2004, nearly 50,000 people (smokers or former smokers) had joined NLST at more than 30 study sites across the country.

The trial (now closed to further enrollment) is slated to collect and analyze data for eight years to examine the risks and benefits of each type of screening. The NLST is a randomized, controlled study and is large enough to determine if there is a 20 percent or greater drop in lung cancer mortality from using spiral CT compared to chest X-ray. The trial is scheduled to last until 2009.

Tags: American Cancer Society, death, LCA, lung cancer, Lung Cancer Alliance, mortality, National Cancer Institute, OMB, research

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