HJBR Nov/Dec 2020

46 NOV / DEC 2020 I  HEALTHCARE JOURNAL OF BATON ROUGE supports an even greater survival advan- tage across a broader age group with less tobacco abuse. Despite the current recom- mendations, only 4 to 5 percent of high- risk patients who meet the criteria actually participate in screening programs in the United States. In Louisiana, we are only screening 2.2 percent of eligible patients; however, the cancer care community is taking steps to provide these patients with awareness and access to these life-saving scans. As the number of patients screened increases, we look forward to a stage shift with a higher percentage of lung cancers being diagnosed at an early stage and with better survival rates. MINIMALLY INVASIVE LUNG RESECTION Per the National Comprehensive Can- cer Network (NCCN) guidelines, surgical resection is recommended in medically COLUMN ONCOLOGY Recent data published in the New En- gland Journal of Medicine, however, demonstrates a sharp reduction in the mortality rates of non-small cell lung cancer (NSCLC), the histologic type that accounts for 80 percent of lung cancers. There have been numerous advances to account for the improved survival over the past decade, including low dose CT screen- ing for early detection, minimally invasive surgical resection techniques and the ad- vent of targeted therapies and immuno- therapies. SCREENING Perhaps the most compelling reason for the high mortality associated with lung cancer is that the majority of lung cancers are diagnosed at an advanced stage when they become symptomatic. Unfortunately, early-stage lung cancers are typically as- ymptomatic and found incidentally or by screening. In 2011, the national lung cancer screening trial (NLST) demonstrated a 20 percent decrease in lung cancer mortality by screening high risk patients with annu- al low dose CT (LDCT) scans. In 2015, the Centers for Medicare and Medicaid Ser- vices (CMS) approved annual CT screen- ings for patients 55-77 years old with a 30 or more “pack year” smoking history and smoking cessation within 15 years. This has allowed for patients at the highest risk of developing lung cancer improved access to screening. Over the past five years, we have learned that lung cancers that are di- agnosed by screening CT scans are more likely to be early stage and thus have an improved survival. Research is currently underway to investigate broadening the criteria for screening. Preliminary evidence ADVANCES IN LUNG CANCERTREATMENT— Improving Survival of NSCLC LUNG CANCER HAS HISTORICALLY BEEN THE NO. 1 CANCER KILLER IN THE UNITED STATES, TAKING MORE LIVES ANNUALLY THAN BREAST, PROSTATE AND COLORECTAL CANCERS COMBINED.