Experts ask to start screening and offer the exam free to those most at risk of getting sick: heavy smokers or ex, over 55. With early diagnosis there would be 5 thousand fewer deaths every year
Many scientific studies around the world have shown this by now: the spiral Tac (low-dose chest computed tomography) effective to find out an early stage lung cancer, when it is easier to cure and the hopes of recovery are higher. With this exam 5 thousand deaths could be avoided every year in Italy. The test that is reliable, safe, acceptable, economically sustainable and capable of modifying the course of the disease. That is, it fully reflects the criteria established by the World Health Organization for screening. An early diagnosis program should therefore be launched (to complement those already existing: mammography for breast cancer, search for occult blood in the faeces for colon and Pap test or Hpv-Dna test for the uterus) to which to invite free of charge the population at greatest risk of developing lung cancer, ie current or former heavy smokers, over 55. To ask, once again, for screening to start in Italy are the doctors involved every day in taking care of the patients affected by the neoplasm who have drawn up the Italian Manifesto PolmoniAMO presented in recent days in Milan.
The deadliest cancer in Italy
Lung cancer, still today, is the most lethal tumor in Italy and, with 41 thousand new cases per year, one of the most frequent. I’m 34 thousand deaths caused in 2021, about 60% of which (as many as 20,400) concern heavy smokers. An easy-to-prevent tumor: it would be enough not to smoke, since 85% of cases are due to tobacco. It is very difficult to identify at an early stage because it does not give symptoms at the beginning and for this reason it remains a big killerwith over 70% of patients who arrive at diagnosis late. With low-dose chest computed tomography, the number of early diagnoses can be increased from the current 25% up to 60%, allowing patients to be nominated for less invasive surgery and treatment with innovative drugs, increasing the chances of recovery. And, it is emphasized in the Manifesto, with an important impact also from an economic point of view, if we consider that lung cancer has a cost of 2.5 billion euros every year, which includes both direct (health) and indirect (social) outputs. Not only, therefore, with the execution of the test and an early diagnosis, those who get sick are more likely to recover or live longer and better, but the advantages are also relevant for the NHS funds that would spend less. Thanks to screening, however, possible today detect very small tumorswhich can be treated with minimally invasive, robotic and personalized surgery.
With Tac to heavy smokers 5 thousand fewer deaths
We want to affirm the urgency and the evidence to promote lung cancer screening and its inclusion among the cancer screenings approved and reimbursed by the NHS included in the Essential Levels of Care (LEA) – he says. Giorgio Vittorio Scagliotti, director of the Division of Medical Oncology of the University of Turin and scientific coordinator of PolmoniAMO (created with the support of AstraZeneca) -. This neoplasm has so far received less attention than others, also because of the social stigma, because the majority of sufferers are smokers. Low-dose Tac represents a promising life-saving strategybut to date it is not part of clinical practice and prevention programs reimbursed by the NHS, while clinical studies have shown that this approach reduces mortality in heavy smokers by 20-25% (at least 30 packages per year), which can translate into over 5,000 fewer deaths every year in our country. As for all types of cancer, time is important: in fact, in that small proportion of patients (only 14%) who discover the neoplasm at the beginning (stage IA) five-year survival rises to 92%. The examination should be performed annually or every two years, depending on the individual hazard.
Exam for heavy smokers or ex, over 55
With the Sostegni-bis Decree Law, 2 million euros were disbursed for the two-year period 2021-2022 to support the first national experimental lung screening program. Thanks to the funding, the Ministry of Health and the Regions have established the Italian Lung Screening Network (RISP). a free early detection program for lung cancer aimed at people between the ages of 55 and 75 who have consumed a pack of cigarettes a day for more than 30 years – he explains Ugo Pastorino, director of thoracic surgery of the IRCCS National Cancer Institute of Milan and scientific coordinator of PolmoniAMO -. They can participate even heavy smokers who have quit for less than 15 years. 19 centers with high multidisciplinary clinical competence are involved throughout the territory. Low-dose computed tomography currently the most suitable tool for the early diagnosis of lung cancer: effective in identifying small lesions (in the order of millimeters); easy and quick (30 seconds); non-invasive, does not require the use of contrast medium and exposes the patient to a low dose of radiation (five times lower than a conventional CT).
The examination also allows the early identification of other smoking-related diseases, such as chronic obstructive pulmonary disease and heart disease – adds Pastorino -: it allows to calculate the degree of calcification of the coronary arteries, which is directly proportional to the risk of heart attack or coronary artery stenosis. With lung cancer screening, therefore, a cardiovascular risk assessment can also be obtained. The signatories of the PolmoniAMO Manifesto also want to promote a cultural change in public opinion, decision-makers and institutions, making them aware of the need to implement screening. They also need to be implemented the anti-smoking centers. To achieve these objectives, funds are needed, which can be recovered from the National Recovery and Resilience Plan, remembers Scagliotti. Tobacco is the main risk factor for lung cancer, linked to others as well 17 types of cancer. The National Prevention Plan 2020-2025 invests heavily in cancer prevention both through inter-sectoral health promotion actions (healthy eating, physical activity, abstention from the use of cigarettes and other tobacco products and from the harmful and risky consumption of alcohol), and through the improvement of participation in cancer screening provided by the NHS – concludes Daniela Galeone, of the Health Prevention Directorate General of the Ministry of Health -. It is also very important to increase the supply of smoking cessation interventions, monitoring the possible emergence of symptoms in former smokers considering the latency times between exposure and onset of smoking-related cancer. Prevention and early diagnosis are crucial issues.
May 25, 2022 (change May 25, 2022 | 10:44)
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