A New Approach to Reducing Lung Cancer Deaths and Extending Lives

By Richard C. Wender, M.D., Chief Cancer Control Officer, American Cancer Society

Important developments are under way that provide increased hope for those at high risk for lung cancer. For the first time ever, leading health care, nonprofit, government and for-profit groups are coming together for a concerted effort around lung cancer screening, representing a huge shift in how we fight lung cancer, the leading cause of cancer death in the United States.

Since the link between tobacco and lung cancer was confirmed in 1958, the primary strategy to prevent occurrence and death from lung cancer has been to reduce tobacco use. And to be sure, that’s still the most important way to prevent the disease. Today, we have the potential to change the course of the disease through not only tobacco control, but also screening high-risk individuals and, for those diagnosed with cancer, matching their treatment approach to the stage and type of lung cancer, including the genetic fingerprint of their particular cancer. Importantly, we want to ensure that these options are available to all adults at high risk.

We’ve seen tremendous technological advancements in recent years, and lung cancer screening is at a point where it can play an important role for those who are at high risk. A major research study found that an advanced screening method – low-dose spiral computed tomography (LDCT) – reduced death from lung cancer by 20 percent compared to standard chest x-rays.

Screening, of course, is just one vital step in our united efforts to reduce deaths from lung cancer. Individuals found to have early lung cancer through screening can often be cured by removing the cancer and preserving the lung. And other advancements in treatment – genetic testing, targeted therapies, and immunotherapy to name a few – hold real promise against the disease.  

But here’s the challenge: Standard health care hasn’t always caught up with the advancements available to us, and too often, screening for lung cancer is not part of the routine discussions between doctors and patients when it should be. We need to change that.

That’s where this new collaboration comes in. The American Cancer Society and a coalition of leading professional, government and non-governmental organizations are coming together to form the National Lung Cancer Roundtable. These groups collectively have the experience, insights and understanding of the disease to create a nationwide agenda and implement a focused strategy to ensure that those at high risk for lung cancer have access to high-quality screening, while also working to ensure patients receive timely, patient-centered, state-of-the-art care for all stages of the disease. I have to thank AstraZeneca for its major support for this effort. 

So who is at high risk and what should you do if you’re in that group? First, it’s important to remember that anyone can develop lung cancer, regardless of whether an individual has ever smoked. If you have any persistent symptoms, such as a new cough that doesn’t go away, or have any other signs or symptoms, check it out with your primary care physician. At the same time, we know that smoking causes about 90 percent of lung cancer deaths. Those at highest risk of lung cancer are those who have smoked the most: current and former smokers beginning at age 55 who have at least a 30 pack-year smoking history, calculated by multiplying the average number of packs of cigarettes smoked per day by the number of years a person has smoked. (For example: 30 “pack years” equals 1 pack per day for 30 years or 2 packs per day for 15 years.)

If you fall into that high risk category or if you’re not sure, make it an urgent priority to talk to your doctor about whether screening is right for you. Don’t wait until you think you may have symptoms; do it today. An open dialogue with your health care provider is always the best approach. And of course, if you are still smoking – regardless of how much or how long you have smoked – you should get help and quit immediately. Smoking doesn’t just cause lung cancer; it causes heart disease, other forms of lung disease, and many different types of cancer.

Our roundtable has a lot of work to do; we’re rolling up our sleeves immediately and getting started and we look forward to updating everyone on our progress. As the head of the American Cancer Society's Cancer Control programs and, perhaps even more importantly, as a doctor who has personally seen too many patients with advanced lung cancer, I’m thrilled at the prospect of saving more lives and extending lives for many more who develop the disease.  

Richard C. Wender, MD, is the chief cancer control officer of the American Cancer Society. He oversees the organization’s domestic and global cancer control programs, including prevention and early detection, patient and caregiver support, programs and services, global cancer control, and partnerships with health systems.