Early Screening as a Weapon in Global Fight against Lung Cancer

Life-Saving Power of Early Detection for Lung Cancer

Medical Imaging Transforming Cancer Diagnosis, Survival Rates

DEC 5, 2024: French professor Marie-Pierre Revel remembers the time when her then 49-year-old cousin, who for her resembles an Italian actress, was diagnosed in 2013 with an advanced form of lung cancer. She says it was a “shock” for the entire family to learn about this preventable ordeal.

As head of the radiology department of Cochin Hospital APHP (Assistance Publique Hôpitaux de Paris, Hôpital Cochin) in Paris, the professor says this was the spark that motivated her to fight the devastating effects of lung cancer, and to detect any sign or symptom as early as possible.

With lung cancer also making her potentially at risk as a former smoker, Prof. Revel further says any participant in lung cancer screening can have a similar better chance at life to be diagnosed at an early stage.

She adds that early detection is important as it decreases the risk of death from lung cancer. For her part, it was because of a computed tomography (CT) scan that she found out there was an “anomaly” within her system in 2019.

Pulmonary Care

A recent webinar on lung cancer screening from Canon Medical highlighted the significance of thoracic oncology and pulmonary critical care, as well as the sheer importance of low-dose CT scan and mobile cancer screening. Participants learned about varying levels of awareness and practices in Western Europe, eastern United States, and South America with regard to lung health and cancer care.

Prof Revel shares her healthcare initiative primarily in France called Lung Cancer Screening using low-dose CT and Artificial intelligence for DEtection (or CASCADE), specifically targeted for French women. She also highlights another initiative called SOLACE, an EU4Health project that aims to strengthen lung cancer screening strategies using structured low-dose CT.

The CASCADE study aims to urgently boost awareness among and increase the participation of women in deprived areas, and evaluate many reading modalities related to thoracic CT exams. CASCADE also focuses on the role of artificial intelligence in lung cancer screening.

The webinar was able to showcase the need to raise awareness primarily in low-dose computed tomography (LDCT) scan imaging and lung cancer screening (LCS).

Early Detection, Better Outcomes

Why is lung cancer screening important? Canon Medical explains that lung cancer screening has played a critical role in saving lives by

enabling early detection,
improving treatment outcomes, and
targeting high-risk populations for preventive measures.

By implementing screening programs, Canon Medical expounds that healthcare professionals can already identify lung cancer at an earlier stage, when treatment options will be more effective and the chances of survival are better and can even significantly improve more.

The emphasis is early LCS for high-risk patients, even those without symptoms, helping detect lung cancer while it may still be curative. Not screening early enough for patients without symptoms can lead to delays in diagnosis, and even to an advancement in lung cancer which may likely be less responsive to treatment.

Low Dose, False Positive

Lung cancer screening with low-dose CT indeed reduces lung cancer mortality, according to Prof. Revel.

But in order to successfully implement LCS programs, there is a need to overcome several challenges, among others, such as the:

proper selection of high-risk individuals,
standardization of nodule classification and measurement,
specific training of radiologists,
optimization of screening intervals and screening duration,
psychological impact of screening on patientsor screened individuals and on their quality of life,
impact of potential false positive findings, and
importance of stopping smoking.

In her Lung CAncer SCreening in French women using low-dose CT and AI for Detection: CASCADE Study Protocol, she revealed that LCS using low-dose CT has been demonstrated to reduce lung cancer- related mortality in large random controlled trials.

The study cited the potential role of AI in improving scanning/screening, in particular comparing the performance of a single CT reading by general radiologists trained in LCS using AI as a second reader, to that of a double reading by expert thoracic radiologists.

Moreover, the professor emphasized a campaign for low-dose CT screening in high- risk women, since many LCS studies have predominantly underrepresented women and only included mostly male participants.

Mobile Screening

A mobile fleet that conducts lung cancer screening, including low-dose computed tomography scans, typically arrives in town squares or local villages to reach more participants or patients.

The presence of a mobile LCS unit can minimize transportation costs for patients, as well as boost visual awareness and brand equity among the townspeople. Canon Medical has provided Dr. Revel a mobile truck with a CT scan to bring this healthcare technology closer to participants or patients in the farthest areas, or to those who have never considered the possibility of ever going to hospitals for screening.

From the Lung to the Heart

Dr. Kyle Chapman reveals his LCS initiative on the mobile cancer screening program at West Virginia University (WVU). Working together for rapid diagnosis and treatment, the WVU mobile team includes pulmonologists, radiologists, thoracic surgeons and pathologists, as well as radiation and medical oncologists.

Dr. Chapman has addressed lung cancer screening among patients in the West Virginian and Appalachian mountain areas, as he cites higher incidence and mortality rates in these parts. He suggests the need for innovative methods to reach the heart of these underserved populations and places like rural Appalachia, and help detect lung cancer early, via mobile lung cancer screening and low dose CT.

Dr. Chapman has already emphasized the fact that coronary artery calcium (CAC) scoring on LDCT can identify calcium deposits in coronary arteries, and can help consider risk modification to prevent cardiovascular disease (CVD) incidents.

However, his network’s research on integrating cardiovascular risk assessment into mobile low-dose CT lung screenings in the rural Appalachian region reveals that it remains unknown if Lung CT Screening Reporting & Data System (Lung-RADS) scoring directly correlates with CAC scores. That study was able to cover a comprehensive analysis of the relationship between lung cancer risk, coronary artery calcium burden, and cardiovascular risk reduction strategies.

Thoracic Surgery

Dr. Ricardo Sales dos Santos, a thoracic surgeon in Brazil, highlighted his network’s efforts in ProPulmão, an LDCT lung cancer screening mobile unit helping high-risk lung cancer populations in Brazilian communities. He also cites the importance of thoracic surgery, which covers the treatment of chest conditions, many of which are related to oncology.

In addressing lung cancer screening via low- dose CT scan and early detection, Dr. dos Santos says he and his team have cited different challenges, such as:

lack of access to hospitals or limited access to and investments in healthcare mostly in rural and certain urban regions,
delays in forwarding cancer cases,
less investment in cancer care and research,
lack of updated information on lung cancer screening among healthcare professionals in these communities, and
difficulties using cutting-edge technologies.

Nevertheless, LDCT screening for lung cancer has indeed demonstrated effectiveness in reducing cancer mortality, according to Dr. dos Santos, citing their comprehensive trial study.

Screening Trial, Equitable Care

Dr. dos Santos has referred to their First Brazilian Lung Cancer Screening Trial (BRELT1) study and initial prevalence round of screening, with the inclusion criteria similar as those of their National Lung Cancer Screening Trial (NLST).

However, the team did not undertake these studies in areas where the incidence of granulomatous disease is high. (Do Current Lung Cancer Screening Guidelines Apply for Populations With High Prevalence of Granulomatous Disease?)

Dr. dos Santos has nevertheless emphasized the significance of mobile CT scanning practices and providing equitable care for lung cancer benefiting people in more rural areas. Moreover, he highlighted both challenges and opportunities for implementing lung cancer screening in Latin American communities.

Although there have been widespread disparities, such as lack of access to water and education, the emergence of mobile CT scanning to more remote communities presents a positive opportunity for people with the offer of cancer screening via CT imaging. Leveling up awareness on lung cancer helps people and patients who may mistake lung cancer for other conditions such as pneumonia.

Early Detection, Saving Lives

Lung cancer, according to Canon Medical, has been one of the most frequent causes of cancer, and even the leading cause of cancer death globally. When patients show symptoms, the disease often has already progressed, with limited options remaining for treatment.

As a result, prognosis in lung cancer tends to be inefficient or even poor, despite advances in cancer treatment. But when experts detect the disease at an early stage, the chances of survival increase dramatically. Consequently, there has been a growing interest in lung cancer screening worldwide as the primary opportunity in reducing lung cancer mortality.

In her advocacy for lung cancer screening and early detection, Dr. Revel of Cochin Hospital says she has been more than satisfied. In fact, she says her dear departed cousin will be very proud of what she has begun for early lung cancer detection, the very reason why she started all of this.

Himex and Canon

Himex Corporation has expressed excitement about its new partnership with Canon Medical, and how it has marked a significant milestone in advancing healthcare solutions in the Philippines.

This collaboration combines Himex’s extensive experience and robust network in the local medical imaging industry, with Canon Medical’s cutting-edge technology and commitment to patient-centric care. Himex and Canon together are poised to deliver unparalleled diagnostic capabilities, ensuring better health outcomes for millions of Filipinos.

Through this new partnership, Himex will be able to further address and answer the needs of the community for quality-assured innovations and technological expertise in diagnostics equipment.

For its part, Canon Medical has said it aims to be a partner in the battle against lung cancer, as it offers a unique set of lung cancer screening solutions such as CT scan technology. Canon said these include a suite of innovative technologies to enhance clinical confidence everywhere, delivering high-quality imaging at low dose, streamlining workflows, and offering comprehensive diagnosis throughout the entire cycle of care.

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