Lung cancer can be cured if detected early

How exactly is lung cancer treated?

Schmitt-Opitz: If lung cancer is suspected, we discuss the case at the weekly “Tumor Board” of the Lung and Thoracic Oncology Center, where all specialists are present. The aim is to agree on a treatment method that offers the best prognosis for the patient. If a lung tumor can be removed, we operate. If the tumor has already spread metastases, combination therapies such as chemotherapy, immunotherapy or radiotherapy are used, but surgery is also sometimes performed at this stage.

What must a lung carcinoma look like before it can be surgically removed?

Schmitt-Opitz: The decisive factors are the location and size of the tumor, but also how well the lung functions in the affected and the remaining section. The general condition of the patient also plays a role. All these factors are taken into account when deciding on the best possible treatment. This applies both to the combination of therapies and to the type of surgery, if any: can it be minimally invasive, with or without a robot? Or does open surgery have to be performed? The experience of the treating surgeon also plays an important role here.

What is the detection rate?

Schmitt-Opitz: In four out of 100 lung screening participants, a lung tumor was detected in time so that it could be surgically removed. This is a high discovery rate by international standards

Frauenfelder: We also have a comparatively low “recall” rate. The “recall” for further examinations goes to people whose diagnosis is not clear. Today, however, high-quality imaging allows us to make fairly clear statements about the quality of tissue proliferation.

How did the lung screening program get started in 2017?

Frauenfelder: International studies have shown that early detection through lung screening can reduce lung cancer mortality by 20 percent. In Switzerland, this means saving over 650 lives a year. We started our studies in 2017 with 75 participants. In 2018, we were able to secure funding from the USZ innovation pool. Although we have been able to continuously expand our pool of study participants, we would like to recruit even more test subjects.

How does a lung screening work?

Schmitt-Opitz: First of all, we clarify with the interested parties whether they meet the requirements. The CT itself takes just ten minutes. Participants without findings will be informed by telephone. If a finding is discovered, the next steps are discussed in a personal consultation.

Who is eligible to take part?

Frauenfelder: We are looking for people between the ages of 55 and 74 who have smoked at least one pack of cigarettes a day for 30 years. Ex-smokers may not be smoke-free for longer than 15 years. The participants benefit from any early detection and in return make the anonymous data available for research. This will enable us to refine the examination process for diagnosis and treatment planning and, together with the study participants, make an important contribution to the implementation of a national lung screening program recognized by the health authorities.

However, there is still no national program. Where does Switzerland stand?

Frauenfelder: Healthcare in Switzerland is regulated at cantonal level. To avoid a patchwork approach, a national lung screening program makes sense. In mid-November 2022, the independent national expert committee on early cancer detection issued a recommendation for a national lung screening program for at-risk groups. This now brings additional momentum to the topic. The groundwork has been done. A national lung screening program will save lives.

What are the practical benefits of the current study projects?

Frauenfelder: We want to use a broad pool of data to further refine the informative value of imaging. In this respect, we will also make greater use of artificial intelligence (AI) in the future.

Schmitt-Opitz: In addition to lung cancer, coronary heart disease and emphysema (destroyed alveoli) also play an important role in the risk group of smokers.