In the Race To Defeat Lung Cancer, Every Day Counts

Awareness, prevention, and screening. Those are the objectives of  World Lung Cancer Day, celebrated each August, and the shared goals of the American Lung Association (ALA)’s LUNG FORCE initiative, a national movement to defeat lung cancer. Through widespread public education and outreach, LUNG FORCE’s World Lung Cancer Day raises awareness about the risk factors for lung cancer and the lifesaving potential of early detection through lung cancer screenings.

Lung cancer is deadly serious business. According to the American Cancer Society (ACS), lung cancer, both small cell and non-small cell,  is by far the leading cause of cancer death for both men and women in the United States, and the second most common cancer in both men and women after prostate and breast cancers (not including skin cancer). Lung cancer accounts for about 13% of all new cancers diagnosed each year, and kills more people than breast, prostate, and colon cancers combined. People over age 65 account for most occurrences of lung cancer, but a small number of people under the age of 45 are also diagnosed each year. For both smokers and non-smokers, men have a 1 in 15 chance of developing lung cancer in a lifetime; women have a 1 in 17 chance. For smokers, the risk is up to 20 times higher.

Fortunately, with awareness, improved screenings, and evolving biomarker testing and cancer treatment options, lung cancer can not only be prevented in many cases, but the devastating effects of a lung cancer diagnosis can be mitigated if treatment begins in time. Together with physicians and life science companies, we must work to educate the public, advance early detection to predict disease sooner, and streamline the development of targeted therapies to improve outcomes for lung cancer patients.

Most lung cancers can be prevented

When it comes to lung cancer, prevention and early detection are the keys to saving lives. Most lung cancers—nearly 90%, according to the ACS–are related to smoking tobacco, and most could be prevented by refusing (or quitting) smoking and avoiding secondhand smoke. Avoiding exposure to radon gas, hazardous dust and fumes, and air pollutants are also crucial to reducing the risk of developing lung cancer. But some lung cancers occur in people without any known environmental risk factors for the disease. As research advances, genetics may play a role in predicting lung cancers.  

Anti-smoking campaigns have done a lot to educate the public about the link between smoking and lung cancer. What’s less well known is the importance of lung cancer screening in high risk populations—namely those who smoke. Unfortunately, most lung cancers are at an advanced stage and have spread widely by the time the cancer is detected, usually after a person reports coughing, chest pain, or other symptoms that lead to testing and discovery. But lung cancers detected at an early stage—before symptoms occur—can often be cured, making early detection a vital weapon in the fight to defeat lung cancer. Early detection through screenings saves lives.

Low-dose CT screening lowers the risk of death from lung cancer

A new screening, a low-dose CT scan of the chest, is proving to be most effective at flagging early stage cancer in individuals with the high risk for lung cancer—long-term heavy smokers. This low-dose CT scan, when used widely across high-risk populations, has the potential to drastically improve lung cancer survival rates. The scan reveals small, abnormal nodules in the lungs, areas that are common in smokers and usually benign, but which could also be early stage cancer. By repeating the scan at intervals, doctors can tell if a nodule is growing or changing over time. As a result, areas that are concerning in appearance can be biopsied to rule out—or discover—earlier stage cancer.

The importance of early detection through screening is significant: When lung cancer is detected early enough, treatment can begin to prevent the disease from developing into a life-threatening illness that can only be managed and never cured. According to the ALA, low-dose CT screening has the potential to reduce cancer mortality by up to 20% and would save 25,000 lives each year.

Should everyone be screened? The answer is no. A study completed by the National Lung Screening Trial (NLST) showed that low-dose CT screening is effective at reducing mortality only in high-risk populations. As of now, screening has a low predictive value for populations that are at lower risk, including those that develop lung cancer after exposure to radon and other environmental hazards. In non-smoking populations, the risk of false positives outweighs the statistical advantage of early detection through screening, but anyone who is concerned should discuss their risk profile with their doctor
Who is high risk and would benefit from screening? The high-risk criteria for lung cancer screening is defined as people between 55-80 years old who have a 30-pack-year history of smoking, including smoking one pack per day for 30 years, 2 packs a day for 15 years, and so forth; or heavy smokers between 55-80 who are current smokers or have quit smoking within the last 15 years. The ALA’s lung cancer risk quiz helps people determine their eligibility for screening. Eight million Americans are estimated to be at high risk for lung cancer. 

Laboratory data holds the key to advancing treatment through targeted lung cancer therapies

Treatment for early and advanced lung cancers can involve surgery, radiofrequency ablation, radiation, chemotherapy, immunotherapy, and, increasingly, targeted therapy drugs. This is where insights from the AI work that Prognos is doing can have a profound impact on the treatment options available to lung cancer patients.

Prognos is the industry leader in applying artificial intelligence and advanced analytics to laboratory data results to find patients based on specific test result ranges and to improve patient outcomes by predicting disease earlier. We work in partnership with diagnostic labs across the United States to take laboratory records and link them with clinical data from providers, practices, and the patients in our anonymized database, using what we discover to segment lung cancer patient populations as well as the health care providers who order lung cancer biomarker testing.

Using advanced analytics, we have discovered factors that influence the rate of testing for various lung cancer biomarkers, and have been able to demonstrate that healthcare providers test at the highest rates for well-established biomarkers—EGFR mutations, the ALK gene arrangement, and PD-L1—biomarkers that offer access to an appropriate targeted therapy. As more and more targeted therapies are being developed, our work points toward the need to positively influence physicians to test for biomarkers that do not yet have well-established or approved targeted therapies. More testing of lung cancer biomarkers leads to more targeted treatment plans, better research and development of targeted therapies, and, ultimately, better patient outcomes.

In the fight to prevent, screen, treat, and defeat lung cancer, every day is World Lung Cancer Day. Join with Prognos in raising awareness of the risk factors for lung cancer and the lifesaving potential of early detection through screenings, as well as the promising future of targeted lung cancer therapies. For more information about Prognos’ coverage reach out to pharma@prognoshealth.com or payer@prognoshealth.com