Progress and prospects of early detection in lung cancer

Open Biol. 2017 Sep;7(9):170070. doi: 10.1098/rsob.170070.

Abstract

Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15-19% compared with 81-85% for stage I.

Keywords: NLST trial; low-dose CT screening; lung cancer.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Adenocarcinoma of Lung
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / genetics*
  • Bronchoscopy / methods
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / genetics
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery
  • Circulating Tumor DNA / blood
  • Circulating Tumor DNA / genetics
  • Early Detection of Cancer / methods*
  • Humans
  • Liquid Biopsy / methods
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Lung Neoplasms / surgery
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / metabolism
  • Neoplastic Cells, Circulating / pathology
  • Prognosis
  • Radiography
  • Small Cell Lung Carcinoma / diagnostic imaging*
  • Small Cell Lung Carcinoma / genetics
  • Small Cell Lung Carcinoma / mortality
  • Small Cell Lung Carcinoma / surgery
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • Circulating Tumor DNA