Low-dose CT scans for lung cancer should be as routine as mammograms.
In 2022, much to my shock, I was diagnosed with small cell lung cancer (SCLC). At the time, I had no idea what small cell lung cancer meant. Naively, I assumed that “small” meant insignificant. It was not insignificant. In fact, among lung cancers, SCLC is the most aggressive, not easily treatable, and life expectancy can be low.
It is being introduced in UK and some other countries for those most at risk but those who have never smoked are excluded as those outside the age range even if they have sufficient smoking history to hit the 'at risk' threshold. As a never smoker, diagnosed at 52 I would not have been eligible even if it was compulsory. Mammograms also have age limits as do many screening tests for cancer - seen predominantly as a condition affecting older people despite there being many of us who don't fit that profile. The perceived harms are considered too risk even with low dose CT scanners - we've introduced mobile units that travel into communities in many parts of the country but there will always be those diagnosed from their symptoms rather than screening a healthy population. what needs to also improve is recognition that anyone can develop, broader awareness of the many symptoms that are possible not only a cough that lasts weeks or coughing up blood and more education in primary care/family doctors about its symptoms, treatments and prevalence.
When I first became involved in lung cancer research more than 10 years ago, I joined a group of clinicians desperate to change the UK's situation and we've gone from discussions to pilot studies to providing the evidence to national policy makers to getting recommendations for lung screening which will hopefully be introduced to the whole of England and Wales by 2028 but there is still some way to go. European countries are also exploring implementing this in different ways so it will come.
Mine was non small cell (adenocarcinoma) but the only targeted treatments at that time were only available on clinical trials for EGFR positive mutations which I didn't have. The treatment landscape has changed beyond recognition since then and although small cell has not had the same types of responses to targeted agents as some non small cell lung cancers, immunotherapy and combination therapies are starting to improve outcomes for some. I had no clue about lung cancer either - as a never smoker, it had never entered my head that I might develop that despite working in the healthcare system for many years at that point. Awareness raising needs to improve in so many areas.
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