Dr. Stephen Lam speaks with TFRI lung study participant Chris Douglas. Photo credit: Chuck Russell.
Lung cancer is the leading cause of cancer deaths in Canada for both men and women. More than one in four cancer deaths are due to the disease and the five-year survival rate is incredibly low. Trying to improve these outcomes for patients is the goal of our Terry Fox pan-Canadian project on the early detection of lung cancer.
Why are the outcomes so poor? The majority of lung cancer patients are only diagnosed after the disease has reached a late stage and the cancer has already started to spread. Patients with early-stage lung cancer have much better survival outcomes, but often they have no symptoms of the disease so early diagnosis is difficult.
I am the program leader on the project and since we started in 2008, we have had great success in developing an accurate prediction tool for physicians. We have created two calculators:
- A lung cancer prediction tool which we used to recruit 2,500 study participants who all had scans taken of their lungs.
- A lung nodule cancer risk prediction tool which we have shown can be used to assess nodules (or lesions) seen in lung scans and classify lung cancer with over 90% accuracy.
So far in our study, 6% of the participants have been diagnosed with lung cancer. The majority were at an early stage of the disease and exhibited few symptoms. If they had not been part of our study, they may not have been diagnosed until the disease had spread. Nearly 75% of lung cancers we detected were Stage I or II. Across Canada over 75% of lung cancers detected at are Stage III or IV. If the majority of lung cancers in Canadians could be detected early, this would greatly reduce the number of people who die from it.
Not only does early detection lead to much better outcomes for patients, we have also found that it can lower the cost of a patient’s treatment. Treating a patient with Stage I or II lung cancer costs less (it can be as much as $14,000 lower) than it does to treat patients with late-stage disease. These findings were published recently in the Journal of Thoracic Oncology (September 24, 2014).
Our work continues with study participants over the next year and we will continue to look for ways to improve our prediction tools.
Dr. Stephen Lam
Program Leader on the Terry Fox Early Lung Cancer Detection Translational Research project