November Is Lung Cancer Awareness Month

Written by Albee Budnitz, MD with Breathe NH (Board Member & Volunteer)

November is Lung Cancer Awareness Month. As the oldest volunteer health agency in NH for more than 100 years, Breathe NH’s (BNH) mission has been to eliminate lung disease and improve the lives of those living with lung disease. Lung cancer remains the #1 cause of cancer death in the USA, but the last 10-plus years have seen the most advances against this disease in more than 50 years. Indeed, it was more than 50 years ago that Dr. Luther Terry issued the first surgeon general’s report on smoking and health, specifically linking smoking to lung cancer. The advances in lung cancer have come in 3 major areas of health care – prevention, screening diagnosis, and treatment.

For a public health agency like BNH and for me, first and foremost is prevention. Use of combustible tobacco, a history of smoking cigarettes remains the cause of more than 80% of lung cancers. And we’ve made remarkable progress in reducing cigarette smoking with overall prevalence down from near 50% in mid-20th century to approximately 10% projected for this year, 2020. But there are still approximately 35 million smokers in the USA. BNH has developed brief to comprehensive smoking cessation educational programs for health care professionals (HCP’s); and similar educational programs relative to “vaping”/e-cigarettes. Use of the latter by youth has shown progression to cigarette smoking! BNH collaborates with multiple similarly-minded state partners to develop and maintain a comprehensive community program to reduce tobacco use. Here is opportunity; join us; more work needs be done.

Second, since the National Lung Screening Trial (NLST) published in 2011 and subsequent data, we finally have a tool for diagnosing lung cancer that can reduce mortality, (by up to 20%), and improve survival in lung cancer patients. Unlike colon or breast cancer screening, lung cancer screening relates to a very specific population; essentially asymptomatic smokers, ages 55-74, with more than or equal to 30 pack years’ smoking, and either currently still smoking or having quit within the last 15 years. Meeting these and certain other criteria gave this lung cancer screening with Low Dose CT scan (LDCT) a grade “B” recommendation from the US Preventive Task Force (USPTF). The importance of this is that under the Affordable Care Act (Obamacare) this screening is a covered benefit without co-pay. Despite this, uptake/referral for this service has been minimal. With multiple statewide partners, primarily hospital systems, BNH, and others meet and collaborate several times a year as an “LDCT best practices” group learning how to improve/increase use of this service. So again, there is opportunity; more work needs be done.

Finally, the treatment of diagnosed non-small cell lung cancer (NSCLC), the most common type of lung cancer, has made more advances in the last 5-10 years than any time prior! And these treatments, immunotherapy and biologics, have both better outcomes and less adverse effects than previous standard chemotherapy. Work on further improving these treatments continues.

In summary, medical science is finally making major headway with this disease – lung cancer. From BNH’s standpoint and mine, the BEST approach is PREVENTION – elimination of tobacco use. But meanwhile, more use of early detection, screening, needs to happen. And treatment continues to improve.

Photo by fotografierende on Unsplash.

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