Lung cancer screening in India: Preparing for the future using smart tools & biomarkers to identify highest risk individuals.

Nithya Ramnath, Prasanth Ganesan, Prasanth Penumadu, Douglas Arenberg, Alex Bryant
Author Information
  1. Nithya Ramnath: Department of Internal Medicine, University of Michigan, United States.
  2. Prasanth Ganesan: Department of Medical Oncology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
  3. Prasanth Penumadu: Department of Surgical Oncology, Sri Venkateswara Institute of Cancer Care & Advanced Research, Tirupati, India.
  4. Douglas Arenberg: Department of Internal Medicine, University of Michigan, United States.
  5. Alex Bryant: Department of Internal Medicine, University of Michigan, United States.

Abstract

There is a growing burden of lung cancer cases in India, incidence projected to increase from 63,708 cases (2015) to 81,219 cases (2025). The increasing numbers are attributed to smoking (India currently has nearly 100 million adult smokers) and environmental pollution. Most patients present with advanced disease (80-85% are incurable), causing nearly 60,000 annual deaths from lung cancer. Early detection through lung cancer screening (LCS) can result in curative therapies for earlier stages of lung cancer and improved survival. Annual low-dose computerized tomography (LDCT) is the standard method for LCS. Usually, high-risk populations (age>50 yr and >20 pack-years of smoking) are considered for LCS, but even such focused screening may be challenging in resource-limited countries like India. However, developing a smart LCS programme with high yield may be possible by leveraging demographic and genomic data, use of smart tools, and judicious use of blood-based biomarkers. Developing this model over the next several years will facilitate a structured cancer screening programme for populations at the highest risk of lung cancer. In this paper, we discuss the demographics of lung cancer in India and its relation to smoking patterns. Further, we elaborate on the potential applications and challenges of bringing a smart approach to LCS in high-risk populations in India.

Keywords

References

  1. J Prim Care Community Health. 2021 Jan-Dec;12:21501327211051484 [PMID: 34663119]
  2. Front Med (Lausanne). 2024 Jan 30;11:1343485 [PMID: 38352145]
  3. J Clin Oncol. 2021 Aug 10;39(23):2574-2585 [PMID: 34236916]
  4. Eur Radiol. 2021 Jan;31(1):475-485 [PMID: 32797309]
  5. JAMA Netw Open. 2022 Sep 1;5(9):e2233840 [PMID: 36178692]
  6. Lung Cancer (Auckl). 2019 Sep 30;10:107-124 [PMID: 31686936]
  7. J Clin Oncol. 2023 Apr 20;41(12):2191-2200 [PMID: 36634294]
  8. Environ Health Perspect. 2014 Sep;122(9):906-11 [PMID: 24911630]
  9. Indian J Med Res. 2024 Nov;160(5):397-406 [PMID: 39737507]
  10. Radiographics. 2018 Sep-Oct;38(5):1337-1350 [PMID: 30207935]
  11. Front Oncol. 2021 Apr 16;11:634316 [PMID: 33937034]
  12. J Thorac Oncol. 2023 Oct;18(10):1277-1289 [PMID: 37277094]
  13. Indian J Med Res. 2022 Feb;155(2):264-272 [PMID: 35946203]
  14. J Assoc Physicians India. 2024 May;72(5):e1-e16 [PMID: 38881114]
  15. N Engl J Med. 2011 Aug 4;365(5):395-409 [PMID: 21714641]
  16. Tob Prev Cessat. 2020 May 04;6:28 [PMID: 32760863]
  17. AJR Am J Roentgenol. 2019 Dec;213(6):1213-1220 [PMID: 31557054]
  18. AJR Am J Roentgenol. 2019 May;212(5):1077-1081 [PMID: 30779667]
  19. Am J Respir Crit Care Med. 2021 Oct 1;204(7):817-825 [PMID: 34252012]
  20. Eur Respir J. 2021 Jan 14;57(1): [PMID: 32732334]
  21. Ann Oncol. 2022 Apr;33(4):395-405 [PMID: 35091076]
  22. Indian J Med Res. 2022 Oct-Nov;156(4&5):598-607 [PMID: 36510887]
  23. Epigenomes. 2022 Feb 04;6(1): [PMID: 35225958]
  24. Indian J Med Paediatr Oncol. 2016 Jul-Sep;37(3):152-7 [PMID: 27688608]
  25. Radiographics. 2017 Nov-Dec;37(7):1975-1993 [PMID: 29053407]
  26. Nature. 2024 Jun;630(8015):181-188 [PMID: 38778098]
  27. J Clin Oncol. 2024 Jun 10;42(17):2026-2037 [PMID: 38537159]
  28. Lung India. 2022 Jul-Aug;39(4):337-342 [PMID: 35848665]
  29. Indian J Cancer. 2012 Jan-Mar;49(1):74-81 [PMID: 22842172]
  30. Int J Hyg Environ Health. 2003 Aug;206(4-5):279-89 [PMID: 12971683]
  31. Cancers (Basel). 2023 Oct 31;15(21): [PMID: 37958411]
  32. Ann Thorac Surg. 2016 Feb;101(2):481-6; discussion 487-8 [PMID: 26409711]
  33. Lancet Respir Med. 2024 Feb;12(2):141-152 [PMID: 38042167]
  34. Radiother Oncol. 2016 Aug;120(2):258-66 [PMID: 27296412]
  35. J Clin Oncol. 2022 Mar 10;40(8):876-883 [PMID: 34995129]
  36. Eur Respir J. 2012 Nov;40(5):1228-37 [PMID: 22653775]
  37. J Thorac Oncol. 2021 Aug;16(8):1250-1266 [PMID: 34304854]
  38. Science. 1987 Oct 9;238(4824):163-70 [PMID: 3310230]
  39. Indian J Public Health. 2018 Jul-Sep;62(3):221-223 [PMID: 30232973]
  40. Radiology. 2018 Jan;286(1):286-295 [PMID: 28872442]
  41. JAMA Netw Open. 2022 Sep 1;5(9):e2237647 [PMID: 36178695]
  42. Front Public Health. 2023 Nov 09;11:1264342 [PMID: 38026274]
  43. J Thorac Oncol. 2022 Dec;17(12):1355-1364 [PMID: 36087860]
  44. Eur Respir J. 2021 Jan 14;57(1): [PMID: 33122336]
  45. Commun Biol. 2020 Mar 19;3(1):134 [PMID: 32193503]

MeSH Term

Humans
Lung Neoplasms
India
Early Detection of Cancer
Tomography, X-Ray Computed
Smoking
Risk Factors
Mass Screening
Biomarkers, Tumor
Incidence

Chemicals

Biomarkers, Tumor

Word Cloud

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