Diagnosis in the localized phase continues to be one of the great challenges in the management of lung cancer, the tumor with the highest mortality. “Diagnosing before, we could apply all the treatments at our disposal that seek a healing intent. We can do that today in less than 25% of cases“, points out Juan Carlos Trujillo, clinical chief of Thoracic Surgery at the Hospital de la Santa Creu i Sant Pau, in Barcelona, and coordinator of the Cassandra project for lung cancer screening.
The remaining 75% of cases are diagnosed at an advanced stage or locally advanced. As he points out, “the techniques have evolved a lot, but the treatment does not offer a guarantee of curing the disease, although it does increase survival. The highest mortality is probably linked to late diagnosis“. The reasons for this diagnostic delay are that these types of tumors do not give symptoms until advanced stages of the disease.
In his opinion, the ideal screening program is one that diagnoses the largest number of patients at an early stage of the disease with the lowest rate of false positives and negatives, “with sensitivity and specificity on par.”
Around the 85% of cases are linked to tobacco use. For this reason, Trujillo emphasizes that primary prevention, in addition to early diagnosis, must focus “on smoking cessation campaigns that work. We have two laws against tobacco that have not been successful.” Aboutl 15% of diagnosed patients who do not smokeconsiders that they are “a therapeutic and diagnostic challenge: they present lung cancers with different biomolecular characteristics from other tumors”.
Both Trujillo and Fernando López-Ríos, head of the Molecular Pathology Section at the 12 de Octubre University Hospital in Madrid, have participated in the project. Visionaries in lung cancer, an initiative whose objective is to act urgently for the prevention and early diagnosis of lung cancer. The report has had the collaboration of more than a dozen personalities from different fields whose recommendations are aimed at better understanding and detection of the disease.