Screening for lung cancer - current status and recommendations

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Published: 29 Mar 2017
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Dr Christine Berg - National Cancer Institute, Maryland, USA

Dr Berg speaks with ecancer at EBMCI 2017 about lung cancer risk and screening in India, considering the environmental factors that contribute to disease development.

She sets out a goal for reducing the need for screening by tackling air quality and pollution.

The National Lung Screening trial is the leading trial showing that lung cancer mortality can be reduced with screening with low dose computerised tomography to find small little nodules in the lung that can be removed and patients can be cured of what is usually a deadly disease, lung cancer. In India there are many issues surrounding lung problems. These problems include tuberculosis, risks from air pollution, risks from indoor air pollution which include cooking oils and actually the incense fumes from some of the religious ceremonies when they’re conducted in enclosed environments. So understanding lung cancer risk in India is really critically important. Tobacco and various tobacco products are used in different frequencies across India and that use is also very important to understand.

Before embarking on lung cancer screening in India it’s really important to look at all of these other factors and address them because they will have the best, most important, long-term impact in terms of lowering lung diseases, lung cancer, problems in children from air pollution, all of these things are really critical. Lung cancer screening can be adopted in selected circumstances; once a high risk population is identified it could be done in a carefully controlled environment with safety features to ensure that if a biopsy is needed it is done to the highest standard. So pilot programmes for lung cancer screening would be good but also it’s critically important for India to pursue the public health endeavours that they have so really excellently embarked upon. I congratulate Tata for helping to lead the charge in this regard.

Ideally what I would like to see happen is that I’m invited back ten years from now and then maybe another ten years from now after that. I think it’s achievable in twenty years that we could have very, very, very low rates of lung cancer; if we’re successful in eliminating tobacco, cleaning up the air, improving methods of cooking, we can eliminate the need for lung cancer screening. That, I think, would be really a wonderful accomplishment and I see India really setting a good example for many other South Asian and Southeast Asian countries and leading the way to help accomplish that.