Abstract
Lung cancer survival statistics are sobering with survival ranking among the poorest of all cancers despite the addition of targeted therapies and immunotherapies. However, improvements in tools for early detection hold promise. The Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON) trial recently corroborated the findings from the previous National Lung Screening Trial low-dose Computerised Tomography (NLST) screening trial in reducing lung cancer mortality. Biomarker research and development is increasing at pace as the molecular life histories of lung cancers become further unravelled. Low-dose CT screening (LDCT) is effective but targets only those at the highest risk and is burdensome on healthcare. An optimally designed CT screening programme at best will only detect a low proportion of overall lung cancers as only those at very high-risk meet screening criteria. Biomarkers that help risk stratify suitable patients for LDCT screening, and those that assist in determining which LDCT detected nodules are likely to represent malignant disease are needed. Some biomarkers have been proposed as standalone lung cancer diagnosis tools. Bronchoscopy technology is improving, with better capacity to identify and obtain samples from early lung cancers. Clinicians need to be aware of each early lung cancer detection method's inherent limitations. We anticipate that the future of early lung cancer diagnosis will involve a synergistic, multimodal approach, combining several early detection methods.
Highlights
Lung cancer is the leading cause of death from cancer worldwide
The team discovered that the fragments of tumour-derived cell-free tumour Deoxyribonucleic acid (DNA) (ctDNA) varied more in length compared to Circulating cell-free DNA (cfDNA), being typically shorter by about 3–6 bases
Subgroup analyses show that miRNAs are more effective in detecting nonsmall cell lung cancer (NSCLC) in Caucasian populations compared to Asian populations; panels of miRNAs were superior to individual, as were blood-derived miRNAs compared to sputum-derived miRNAs
Summary
Lung cancer is the leading cause of death from cancer worldwide. To improve survival, there needs to be a shift in the stage of disease at which it is first diagnosed along with timely and successful treatment. The median volume doubling time (VDT) of NSCLC is believed to be 121 days with 41% of lung cancers having a VDT of < 100 days [10], corroborating the need to act quickly Yang et al sought to correlate the timing of lobectomy with survival outcome in just under 5000 patients who had stage IA squamous cell lung cancer (LUSC) between 2006 and 2011. They found that a delay of more than 37 days from time of diagnosis to surgery was associated with worse survival [11]. It finishes by exploring the early detection and treatment of central lung cancers
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