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Study shows decrease in certain lung cancer deaths

Image with caption: Apar Ganti, MD

Apar Ganti, MD

A lung cancer expert at UNMC says a large, yearlong study underscores the need for increased -- and regular -- screenings for lung cancer.  

Study results, which appeared in the Journal of the American Medical Association’s Oncology on Oct. 21, update the incidence of lung cancer in the U.S. and emphasize the importance of earlier detection and newer treatments in improving survival from lung cancer.

UNMC’s Apar Ganti, MD, said the results were significant and suggest that as lung cancer is diagnosed at earlier stages, survival increases. First author on the study, Dr. Ganti is a lung cancer expert in the UNMC Division of Oncology-Hematology and sees patients at Nebraska Medicine and the VA Nebraska Western Iowa Health Care System.

In the study, he found the incidence of one type of lung cancer -- non-small cell lung cancer -- decreased between 2010 and 2017 in the United States. "This was mainly due to a decrease in the incidence of stage II to stage IV lung cancer," he said. "The five-year survival was 26.4%, which was higher than has been previously reported."

Dr. Ganti also found the use of screenings to detect early lung cancer woefully underused. He said he hopes information from the study will encourage more lung cancer screening.

"Diagnosing lung cancer at an earlier stage is important and lung cancer screening should be emphasized," he said.

Screenings, he said, are with a low dose CT scan and are approved by the U.S. Preventive Services Task Force and paid for by insurance.

"Unfortunately, screenings for lung cancer are not as common as we would like, he said, noting physicians must order it, but patients can request it from their primary care provider. In Nebraska, in 2018, less than 4% of eligible individuals received lung cancer screening.

He said the task force recommends yearly lung cancer screening for people who:

  • Smoke at least 20 packs or more a year
  • Smoke now or have quit within the past 15 years and
  • Are between 50 and 80 years old

Dr. Ganti said the study also supported earlier findings that patients over the age of 65 with stage IV lung cancer were less likely to be offered treatment.

"The most common reason seems to be that oncologists and patients alike feel they may not be able to tolerate treatment, even though the majority of the research shows that a fit older person does just as well as a fit younger person," he said.

Pharmaceutical company AstraZeneca funded the yearlong study, which analyzed information from the Surveillance, Epidemiology and End Results, a large database that included cancer patients in the United States. The team studied information on 1.28 million people.

Risk factors

According to the U.S. Centers for Disease Control and Prevention, smoking has declined from 20.9% (nearly 21 of every 100 adults) in 2005 to 14.0% (14 of every 100 adults) in 2019.

Risk factors for lung cancer include:

  • Smoking cigarettes, pipes or cigars, now or in the past (the most important risk factor for lung cancer)
  • Being exposed to secondhand smoke
  • Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot or tar in the workplace
  • Being exposed to radiation from any of the following: radiation therapy to the breast or chest, radon in the home or workplace, imaging tests such as CT scans, atomic bomb radiation, living where there is air pollution, a family history of lung cancer, being infected with HIV, taking beta carotene supplements and being a heavy smoker.

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