Advances in early detection and therapy make lung cancer treatable and survivable

Advances in early detection and therapy make lung cancer treatable and survivable

For decades, lung cancer has been associated with stigma, fear and loss. Advances in screening, treatment and survival have created a new reality; Lung cancer is treatable, survivable and is increasingly understood by many as a chronic disease. A special edition of theJournal of the American College of Radiologypublished by Elsevier and in collaboration with the American Cancer Society's National Lung Cancer Roundtable (ACS NLCRT), details this shift and describes how radiology is moving beyond disease detection to providing equitable care and becoming a champion of patient dignity.

Cancer is the second leading cause of death in the United States and the leading cause of premature death as measured by years of life lost. Lung cancer is by far the leading cause of cancer death, killing more people in the United States each year than the next two causes of cancer death combined in men and women. In 2025, an estimated 226,650 cases of lung cancer will be diagnosed and 124,730 deaths from lung cancer will be recorded.

Transformation of the radiology landscape

A cross-cutting theme reflected in this special issue is the transition from counting scans to measuring impact across the continuum of care.

Lung cancer screening has evolved into a system of care. It's not just about increasing intake; It is about ensuring that those under investigation are reached equitably, managed appropriately and supported holistically. The next step is to ensure that every patient in every setting experiences screening as humane, coordinated and equitable.”

Lisa Carter-Bawa, PhD, MPH,co-guest editor,Center for Discovery and Innovation at Hackensack Meridian Health, Nutley, NJ, and Georgetown Lombardi Comprehensive Cancer Center, Washington, DC

Contributors to the special issue identify the following four core principles that define the changing lung cancer screening and treatment landscape:

• Radiologie als integrierender Knotenpunkt: Screening ist keine isolierte Dienstleistung mehr. Die Radiologie verbindet Prävention, Tabakbehandlung, Diagnosepfade, Biomarkertests und Überlebensressourcen systemübergreifend, um die Fragmentierung der Versorgung zu verringern.
• Wert vor Volumen: Erfolg bedeutet nicht nur mehr LDCTs (Low-Dose-CT-Scans), sondern auch eine gleichberechtigte Reichweite, angemessene Nachsorge, Einhaltung, Strahlenschutz und die Minimierung von Schäden.
• Menschliche Erfahrung ist wichtig: Angst vor Scans und Ergebnissen sowie Stigmatisierung im Zusammenhang mit der Rauchergeschichte können das Vertrauen der Patienten untergraben, das Engagement verringern und die langfristige Therapietreue beeinträchtigen. Programme, die Empathie, Klarheit und respektvolle Kommunikation in den Vordergrund stellen, verbessern das Engagement.
• Verfeinerung der Personen, die wir untersuchen: Der Einsatz epidemiologischer Studien zur Verfeinerung der Zielgruppe für das Lungenkrebs-Screening ist von entscheidender Bedeutung, um beim Screening von Personen mit hohem Risiko das Gleichgewicht zwischen Schaden und Nutzen aufrechtzuerhalten.

Articles in the special issue detail the full scope of lung cancer screening, including eligibility requirements (including the ability to leverage high mammography participation to engage women), strategies to increase uptake through community-based and government interventions, a discussion of screening harms such as scanxiety, as well as radiation dose management, and ongoing implementation issues such as system operability, challenges with rural multidisciplinary collaboration, and cannabis use among screened individuals.

Maximizing impact and reframing the narrative

Co-Guest Editor Ashley Prosper, MD, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, notes: "Clinical studies and reports from real-world screening programs have confirmed that lung cancer screening is a worthwhile endeavor with the potential to significantly improve lung cancer outcomes. Maximizing these positive impacts requires a combination of strategic multidisciplinary partnerships, effective communication, and informatics tools to address data gaps between radiology and primary care close.” Care and oncology essential to timely diagnosis, appropriate follow-up and equitable outcomes.”

Co-guest editor Julie Barta, MD, Jane and Leonard Korman Respiratory Institute, Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA, states, "While we know that lung cancer screening improves early detection and reduces lung cancer mortality, there is still much work to be done to understand how we identify high-risk patients for screening and provide high-quality care."

The authors emphasize that achieving this systemic transformation requires a concerted effort to reduce the historical stigma and fear associated with the disease and replace it with a message of hope.

"Lung cancer is treatable and survivable. Every single patient deserves to know that. Radiologists and their teams are an integral part of the medical community, and together with our primary care physicians and colleagues, we can help expand knowledge and awareness of what is possible and replace nihilism and stigma with empathy and hope for patients and their families," added Ella A. Kazerooni, MD, MS, chair of the American Cancer Society's National Lung Cancer Roundtable (ACS NLCRT). added Terry M. Silver Professor of Radiology and Professor of Internal Medicine, University of Michigan, Ann Arbor, MI.

"The question is no longer whether lung cancer screening saves lives - it does - but how we ensure that its benefits are implemented fully, equitably and with dignity. Radiology is uniquely positioned to lead this charge," concludes Dr. Carter Bawa.

Sources: