Lung cancer is sometimes seen as the invisible cancer, the one that people bring on themselves through smoking or other bad decisions. But the truth of the matter is that on average, more people die in the UK from lung cancer than any other type of cancer, accounting for 21% of all cancer deaths.
It is also an illness which tends to affect those from deprived areas of England more than others, taking older patients more readily than those who are aged between 18-39 https://scienceblog.cancerresearchuk.org/2011/07/08/new-horizons-for-lung-cancer/. Its survival rate has not improved much over the past 40 years, which is thought to be down to the lack of early lung cancer diagnosis. Those with the disease are unlikely to show any symptoms until the cancer has developed significantly. Clinical trial advances in lung cancer have also been slow, particularly when compared to other cancers such as breast and cervical cancer.
Clinical trials involving lung cancer screening are not a new concept. These began in the 1950s where UK and US men who were thought to be at risk were offered chest X-rays to rule out possible cancer. The trial was considered a failure as it didn’t reduce the number of lung cancer deaths. The trials were shelved. Further scans in the late 1970s also had disappointing results, despite using CT scans. This also added concerns of radiation exposure. The 1990s saw even more trials take place, but despite improved CT technology, these were hampered by small trial numbers.
It wasn’t until 2002 that larger scale adaptive phase 1 clinical studies such as those offered at Richmond Pharmacology richmondpharmacology.com/specialist-services/adaptive-phase-i-studies were introduced that the world began to take notice. A group of 53,000 volunteers were screened for stage 1 lung cancer annually for three years using CT scans vs chest X-rays. Exciting results showed a 20% reduction in the number of lung cancer deaths amongst the test group when compared to those with X-rays only.
However, any clinical trial has limitations. We still do not fully understand how lung cancer develops. Some cancers require no treatment at all as our immune system can deal with them effectively. Screening in some cases, then, is unnecessary. Perhaps more research is required into the biology of the disease itself before diagnostic research is completed.