Lung cancer screening: the cost of inaction

Context

Lung cancer accounts for the greatest public health and economic burden of all cancers. Across the world, it is responsible for one in every five cancer deaths. Earlier detection of lung cancer could significantly reduce this burden, transforming it from a fatal condition to one that is treatable.

Prognosis for lung cancer is poor compared with most other cancers. This is largely because many cases are detected at an advanced stage, when treatment options are limited. Five-year survival for stage I lung cancer can be as high as 68–92%, but only around one fifth of people with lung cancer are diagnosed at this stage. More than twice as many people receive their diagnosis as stage IV, when their likelihood of surviving five years is less than 10%.

Shifting diagnosis of lung cancer to an earlier stage could thus lead to a substantial reduction in the number of deaths from lung cancer. This would, in turn, dramatically reduce the economic toll of cancer on our societies. The most effective way to achieve such a shift is via targeted screening with low-dose computed tomography (LDCT).

Trials have shown that LDCT screening has the potential to reduce lung cancer deaths among high-risk individuals by almost a quarter. In light of this evidence, the time has come for governments to consider implementation of targeted lung cancer screening. Experts suggest it compares favourably with other cancer screening programmes in terms of cost-effectiveness. Moreover, its benefits extend beyond lung cancer, as targeted LDCT screening also has the potential to detect other non-communicable diseases, such as chronic obstructive pulmonary disease. Investing in early detection of lung cancer is also an investment in the future sustainability of our health systems and post-pandemic recovery.