Screening strategies for early detection of lung cancer: the time is now.

Abstract

CURRENT KNOWLEDGE AND AVAILABLE TECHNOL -ogy could change the outcome of lung cancer. But screening and even case finding in patients at high risk is still not recommended. No major medical organization in the United States recommends any form of screening for lung cancer. For this reason, lung cancer is not diagnosed until it is symptomatic and usually when it is in advanced and incurable stages. Assume that the following facts are true: In the year 2000, approximately 172 000 patients will be diagnosed as having lung cancer, which represents the most common fatal malignancy in both men and women in the United States (based on 1996 data),' and the 5-year survival rate will be only 15%, which is a generous estimate. Simple arithmetic results in 25800 patients who will survive and 146200 patients who will have progressive, rapid, and painful deaths from lung cancer, often with bone and brain metastases. However, the survival rate in early-stage lung cancer, that is, in situ and stage IA, is 60%, which also is a conservative estimate. Thus, if all 172000 patients could be diagnosed at this early stage, this would result in 103200 survivors and 68800 deaths in 2000. Diagnosing and treating lung cancer in the early stages of the disease could save tens of thousands of lives each year.