Showing the way ahead for lung cancer screening

Background

Lung cancer causes more deaths in Australia than any other cancer. Smoking is the primary factor that puts people at risk, with 80% of lung cancers occurring in people who were smokers.

Unfortunately, the majority of lung cancer cases are diagnosed at a late stage as early diagnosis is difficult as the symptoms can often be vague and non-specific. Lung cancer screening with low-dose computerised tomography (LDCT) is promising, but is only effective at reducing mortality in people at the highest risk of lung cancer. This makes targeting the right group of people for screening essential – screening everyone who has ever smoked a cigarette would be ineffective and would result in unnecessary invasive testing, costs and psychological distress.

The research

• The study investigated how reliably a risk tool developed in the USA and Canada would predict lung cancer outcomes in Australians by looking at almost 100,000 Australian current and ex-smokers who are part of the Sax Institute’s 45 and Up Study.
• The tool uses a mathematical formula to combine risk factors (including age, smoking intensity, duration, years quit, body mass index and family history) to predict someone’s risk of being diagnosed with lung cancer in the next six years.
• The researchers then compared the tool’s predictions with how many smokers in the 45 and Up Study went on to develop lung cancer and found the tool had excellent predictive performance in Australia. It correctly predicted nearly 70% of all subsequent diagnoses.