Here at Lunglead we are supporting Movember and the Movember Foundation, the international organisation committed to changing men’s health, in particular by saving and improving the lives of men affected by prostate cancer, testicular cancer and mental health problems.
But did you know that November is also Lung Cancer awareness month. What started as a single day in 1995 has grown into an international campaign to raise awareness of the disease, how to prevent it, and what to look out for to try to increase early diagnosis. It is supported by the Roy Castle Lung Cancer Foundation which provides educational materials that can be ordered or downloaded here.
In the UK more than 40 000 people are diagnosed with lung cancer each year with about 35 000 a year dying from it, making it the commonest cause of death from cancer in the UK. Early disease can be curable but most patients present with advanced disease when treatment has little impact on survival. The UK still has poor lung cancer survival rates and high early mortality, compared to other countries and a recent study by O’Dowd et al from Nottingham has shown that patients who die early are interacting with primary care prior to diagnosis, suggesting that there are opportunities to identify them earlier in the disease process.
One way of tackling this is to increase awareness of lung cancer symptoms amongst the population, such as the UK national ‘Be Clear on Cancer’ campaign in 2012 which targeted smokers with cough of more than 3 weeks duration. Results from public health England showed a 9% increase in diagnosis of lung cancer, with a shift towards earlier stage disease detection and a 2% increase in resection rates during the study period and results from local centres confirmed these trends.
Another way of tackling this is to establish a screening programme that could detect lung cancer at an early stage to allow effective treatments to improve it’s prognosis i.e surgical resection, that was safe with a with a low percentage of false-positives to avoid unnecessary harm and be cost-effective. The largest study to investigate this was the U.S. National Lung Screening Trial (NLST) which randomised more than 53 000 people aged 55-74 years who had smoked in the past 15 years and had accumulated a minimum of 30 pack years to three annual screens with low dose computed tomography or chest X-ray. It found a 20% relative risk reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality. It is estimated that for every 1000 people screened, low dose CT-screening reduces 5 deaths (3 from lung cancer), leads to 4 cases of over diagnosis, 242 people experience a false-positive and there is still an undefined risk of individuals potentially developing radiation-induced cancers. Some have recommended lung cancer screening for individuals fulfilling the NLST selection criteria and this has been incorporated into ACCP guidelines published last year, whilst others have suggested waiting for results of European trials which should report in 2015 and should give more information on mortality and over diagnosis.
In the meantime though, remember, remember November isn’t just about moustaches, let’s support efforts to raise awareness and work towards earlier diagnosis of lung cancer.