“Lung cancer screening could save 500 lives a year.”

Since 2019 ongoing The first pilot project in Sweden to screen for lung cancer. During the first phase, the project targeted women aged 55–74 years in the part of Greater Stockholm that forms the Södersjokhuset catchment area.

In the next stage Both women and men will be offered to participate in the Stockholm project. In addition, similar pilot projects are about to start in the Västra Götaland region and in the Västerbotten region.

– We want to build the knowledge base that the National Board of Health and Welfare needs so that it can finally go ahead and start a national screening program for lung cancer in risk groups, chief physician Gunnar Vagenius tells Läkemedelsvärlden.

He is active at the Lung Tumor Center at Karolinska University Hospital and one of the people responsible for the Stockholm study.

It causes most deaths from cancer

As is known, the main cause of lung cancer is tobacco smoking. But despite the fact that smoking in Sweden is steadily declining, now down to six percent, lung cancer continues to increase. This is because the disease takes a long time to develop, which means that someone's smoking habits 30 years ago can affect that person's lung cancer risk today.

The rise of lung cancer In Sweden, it occurs today among women, while a certain decrease is observed among men. This reflects that men were more advanced in starting and quitting smoking in the twentieth century.

In 2021, around 4,100 people were diagnosed with lung cancer, making the disease one of the most common forms of cancer in Sweden. It is also the diagnosis that causes the most cancer deaths.

Find out too late

The fact that so many people die as a result of lung cancer is largely due to the fact that the disease is usually discovered when the disease has already begun to spread in the body. Symptoms can be widespread and difficult to interpret. A cough, for example, can have many causes, not least in a person who smokes.

this, no At the time of diagnosis, the cancer had spread in 55 percent of patients. Then the disease can no longer be cured, but treatment aims to slow the progression of the disease and relieve symptoms.

In recent years, immunotherapies, Lakimedelsvarden reported, have increased these treatment options

– But earlier In the context of the disease, the more we can make a diagnosis, the more effective curative treatment can be provided by surgery or a combination of radiotherapy and cytostatics, says Gunnar Vagenius.

We hope to save many lives

This is where the discussion of lung cancer screening comes into play. It is a two-stage rocket in which people who have an increased risk are first identified, based primarily on smoking habits. A scan of the lungs is offered so that they can detect lung cancer early enough that it can be treated.

– There are many About convincing research from both the US and Europe showing that such screening saves lives. If we translate this to Swedish conditions, we could save 500 lives a year, says Gunnar Vagenius.

This is believed to hold true for the next few decades before the decline in smoking begins to seriously impact lung cancer numbers.

– There is one Now is a window where we can save many lives and it is important that we get started quickly.

Most of the calls will come

In the first phase of the Stockholm project, about 35,000 women received a letter informing them of the study and offering to answer an online questionnaire. This includes questions about smoking habits.

thus Those who have an increased risk of developing lung cancer are identified. They are offered a lung CT scan at Karolinska University Hospital in Solna. Smokers are also provided with information about contacting the Stop Smoking Helpline for smoking cessation support.

Preliminary results show that about a third of those who received the survey responded. Of those who responded, approximately ten percent met the risk criteria and were called for screening. Of those who received the summons, 94% attended the survey.

– This is it Very exciting numbers for us. The presence of so many people being contacted differs from other screening programmes. Here, we're addressing an at-risk group directly, and that seems to make people very motivated to come to the survey, says Nina Markholm Nordgren, project director of the Stockholm study.

As well as men in the next stage

In April, the lungs of 1,000 people at risk will be examined, the goal of the first phase of the project. So far, lung cancer has been detected at an early stage in eight operable participants.

– They didn't have anything Symptoms at all. Without the test, they would have received treatment later, Gunnar Vagenius says.

In the second phase, the survey will be sent to men and women between the ages of 55 and 74. Here again, the idea is to continue until 1,000 people have been scanned using CT.

Many side projects

In addition to evaluating costs and benefits, project workers also want to answer a number of other questions about lung cancer screening. In several side projects, they, for example, investigate how best to reach different populations with a screening offer.

And for A shortage of radiologists should not put things in a hurry for future national screening, and an AI model is now being trained to be able to help review chest X-rays. The model is trained using images from project participants.

Dialogue with the National Council for Health and Social Welfare

Nina Markholm Nordgren and Gunnar Vagenius hope that their project and two other pilot projects will change the National Board of Health and Welfare's previous reluctance towards lung cancer screening.

-We have one “The very positive dialogue with the National Board of Health and Welfare now shows great interest in our work,” says Nina Markholm Nordgren.

– We hope that our study will lead to answers to their questions.