Early Lung Cancer Screening Program Dramatically Increases Survival Rates

Despite progression in targeted therapy and immunotherapy treatments, the best tool to fight cancer deaths is early diagnosis through low-dose CT screening prior to symptoms, according to findings of a 20-year international study.

Lung cancer is the leading cause of death, with the average lung cancer 5-year survival rate being 18.6%, according to the American Lung Association. Additionally, only 16% of lung cancers are diagnosed at an early stage, and more than half of people with lung cancer die within a year of being diagnosed.

“While screening doesn’t prevent cancers from occurring, it is an important tool in identifying lung cancers in their early stage when they can be surgically removed,” said the study’s lead author, Claudia Henschke, PhD, MD, professor of radiology and director of the Early Lung and Cardiac Action Program at the Icahn School of Medicine at Mount Sinai in New York, in a statement.

The findings of the 20-year international study on early-stage lung cancer screening will be presented at the annual meeting of the Radiological Society of North America. Henschke and colleagues created the International Early Lung Cancer Action Program (IELCAP) in 1992, a multi-institution, multinational research program that has enrolled more than 87,000 participants from over 80 institutions and delivered annual low-dose CT screening for lung cancer.

“Symptoms occur mainly in late-stage lung cancer,” said Henschke. “Thus, the best way to find early-stage lung cancer is by enrolling in an annual screening program.”

In 2006, the researchers published 10-year findings, including an 80% survival rate for patients whose lung cancer was identified by CT screening.

In the new findings, the 20-year survival rate was 80% for the 1285 IELCAP participants who received a diagnosis of early-stage lung cancer. Additionally, the survival rate for patients with nonsolid cancerous lung nodules (n = 139) and patients with partially solid nodules (n = 155) was 100%, while the survival rate for patients with solid nodules (n = 991) was 73%.

“What we present here is the 20-year follow-up on participants in our screening program that were diagnosed with lung cancer and subsequently treated,” said Henschke. “The key finding is that even after this long a time interval they are not dying of their lung cancer.”

The researchers also estimated survival rates for clinical stage IA lung cancers and for resected pathologic stage IA lung cancers measuring 10 mm or less, finding a survival rate of 86% for participants with clinical stage IA lung cancer, regardless of nodule consistency. For participants with pathologic stage IA lung cancers 10 mm or less in diameter, the 20-year survival rate was 92%.

The results of this study show that after 20 years, the patients who were diagnosed with lung cancer via CT screening had significantly better outcomes, stressing the importance of routine and early screening. By identifying the cancer when it is small enough to be removed, patients can be effectively cured in the long term.

“Ultimately, anyone interested in being screened needs to know that if they are unfortunate enough to develop lung cancer, that it can be cured if found early,” said Henschke.

Reference

Henschke C, Yankelevitz DF, Libby DM, Smith J, Pasmantier M, Yip R. 20-year lung cancer survival rates in the International Early Lung Cancer Action Program (IELCAP). Presented at: Radiological Society of North America; November 27-December 1, 2022; Chicago, IL. Accessed November 22, 2022. https://press.rsna.org/timssnet/media/pressreleases/PDF/pressreleasePDF.cfm?ID=2380