SPONSORED FEATURE: INTERNATIONAL ASSOCIATION FOR THE STUDY OF LUNG CANCER
carcinogens varies largely from one country to another smoking prevalence has led to rapid decreases in lung
and from one area to another and across time, from the cancer incidence.
most developed country to the developing countries.
Although, worldwide use of asbestos has decreased, ‰ Low dose lung cancer helical screening: On 29 June
industrial consumption is increasing in many developing 2011, the National Lung Screening Trial (NLST),
countries. sponsored by the National Cancer Institute in the United
States showed that lung cancer deaths fell by 20% and all-
‰ Lung cancer survival: Overall, the 5-year survival rate of cause mortality fell by 7% when smokers, defined as
lung cancer patients is approximately 15%, whereas the 5- current or former smokers with 30 or greater pack years
years survival for patients with surgically resected early of smoking, were screened regularly using low-dose spiral
stage disease is 60–80%. This difference in lung cancer computed tomography (CT) compared with standard chest
survival between those treated with early versus late x-ray. The study followed more than 53,000 current and
stage lung disease makes it crucial to detect lung cancer former smokers aged 55 to 74. It was halted a year early
earlier. In particular, in non-developed countries and because the reduction in cancer deaths provided an
developing countries, access to expensive therapies for answer to the study's main question3. Thus, low-dose
advanced lung cancer is lower than in developed countries spiral CT is the first test of any type to demonstrate a
and detecting the lung cancer at early stages, when significant reduction in lung cancer mortality through
curable by surgery, is still of greatest importance. early detection. This innovation provides a great
opportunity for lung cancer clinicians and researchers
‰ Lung cancer awareness: A number of useful strategies across the world to work responsibly to provide, study and
have been tested to help raise public awareness of early refine this new approach within future clinical trials and
signs and symptoms of lung cancer and to encourage national screening programmes.
people to attend health care providers earlier. These have Although the NLST is the first randomized clinical trial to
included such strategies as local free paper and local press show a significant decline in lung cancer deaths, there are
campaigns, local radio, leaflets, beer mats, “coughing bus a number of European trials currently under way that
stops”, and outdoor bill boards which have been tested in could provide further data on cost effectiveness and
the UK. The authors evaluated the effectiveness of a mix mortality benefit. The IASLC CT screening workshop
method campaign on lung diagnosis and found that there 2011 recommendations listed six priority areas to be
was a positive effect on the target groups, with an increase addressed before the implementation of international
of presentations to GP services and requests for Chest x- national screening programmes4. Lung cancer screening
rays. In conclusion, there is support for the efficacy of the still has to be shown to be cost effective before
“push-pull” approach, combining both public and implementation into developing health care systems.
professional interventions to increase service access and
earlier diagnosis in a socially deprived community with a ‰ Lung cancer staging and interventions: Lung cancer
high incidence of lung cancer1. Awareness strategies could specialists around the globe use an internationally
potentially be incorporated into developing health care accepted classification of lung cancer stage based on the
systems. TNM system. This is the strongest prognostic tool in lung
cancer and assists clinicians in deciding the best treatment
‰ Tobacco control: If the global epidemic of lung cancer for individual patients. IASLC developed its Lung Cancer
deaths is to be decreased in the next few decades, Staging Committee to facilitate improvements in this
smoking cessation must be a key component of our staging system. The project collected data on over
2
strategy . In order to achieve its goal of eliminating lung 100,000 cases of lung cancer from around the globe. The
cancer the IASLC emphasizes the importance of analysis of this data lead to recommendations which
governmental implementation of the Framework of formed the basis of the seventh edition of the TNM
Convention on Tobacco Control with its full array of well Classification for Lung Cancer by the Union of
proven tobacco control strategies International Cancer Control (UICC) and the American
[http://iaslc.org/policies/declaration-on-tobacco]. The Joint Committee on Cancer (AJCC). IASLC remains
example of California is informative of how quickly good committed to fund prospective data collection to inform
tobacco control with its resultant decrease in adult future revisions of this important prognostic tool. The
CANCER CONTROL 2013 51