Early diagnosis and tackling stigma: Improving lung cancer outcomes

Samiran Dey, European business development manager, Fujifilm Healthcare Europe, shares thoughts on pulmonology, lung cancer screening programmes across Europe, the challenges within the therapy area and the upcoming innovation.

Throughout my experience working with those in respiratory medicine, the stigma surrounding lung cancer has remained persistent. The prevailing notion that individuals have absolute control over their diagnosis of lung cancer has fostered a harmful environment within the respiratory community. Consequently, patients may be hesitant to seek help at the early stages, efforts to enhance current practices may receive diminished support, and patients often face profound mental health challenges.[i] While I appreciate and continue to encourage the efforts of the industry in addressing this issue, further action is necessary to advance patient outcomes.

Lung Cancer Screening Programmes across Europe

We are beginning to see real progress from lung cancer screening programmes across Europe based off the protocol of the NELSON study.[ii] The pioneering Targeted Lung Health Check programme, spearheaded by various local initiatives across different areas of the United Kingdom, has set an exemplary standard that serves as a crucial model for other European nations. Moreover, the recent lung cancer screening pilots announced by several European countries demonstrate a shift in focus within healthcare systems - finally acknowledging the significance of this often-marginalised patient group.

During my attendance at the European Congress for Bronchoscopy and Interventional Pulmonology, I had the privilege of engaging in insightful discussions Spain's Cassandra project, a large-scale lung cancer screening audit of local lung cancer screening pilots. The ambitious expansion of this project to encompass forty hospitals, facilitating vital screening for those in need, was particularly promising. These collective efforts reflect a significant stride towards prioritising lung cancer screening and ensuring better care for patients.

Building on this success

As these programmes have the potential to become the "gold standard" of lung cancer screening in the next five years, it is essential to shift our focus towards their national implementation to ensure widespread access. This requires healthcare systems to secure adequate funding to implement these pilot programs on a national scale. Additionally, it is crucial to develop specialised capacity, both in terms of medical devices such as low-dose CT scanners and the professionals operating and interpreting these tools. Specifically, in the UK, the British Thoracic Society has identified a shortage of doctors training to become respiratory specialists, which could impede the potential benefits of these programs across Europe.[iii] To address this, clinicians, particularly in primary care, must be provided with the necessary support and resources to ensure correct refferal takes place.

Furthermore, an ongoing priority should be the active engagement of marginalised communities in these national pilot schemes and subsequent implementation programs. Discussions during recent meetings with clinicians have emphasised the importance of ensuring participation from marginalised communities. True representation within these pilot schemes is crucial to ensuring that these communities can fully experience the benefits of expanded lung cancer screening. Efforts should be made to address any barriers and promote inclusivity and equity in accessing these programs.

By addressing funding, specialised capacity, support for clinicians, and inclusive participation, we can work towards achieving widespread access to lung cancer screening programs and maximising their impact across Europe.

Role of Industry

I fully understand the importance of industry support in these programs, as emphasised through ongoing discussions with clinicians. Raising awareness and challenging the existing stigma surrounding lung cancer, so patients understand that lung cancer can affect anyone regardless of smoking history, is vital to ensure that all patients feel encouraged to come forward for screening if they qualify for enrollment.

Furthermore, prioritising the training of the next generation of clinicians is a clear focus for me in my role at Fujifilm. These clinicians will play a pivotal role in addressing respiratory backlogs across Europe, and their education is vital to this process. With the anticipated increase in diagnostic bronchoscopies, it is essential to promote the training of doctors and nurses who will perform these procedures through our European-wide training programmes. By investing in the education and training of future healthcare professionals, we can enhance the capacity to meet the growing demands and provide better care for patients.

Industry support, raising awareness, challenging stigma, and investing in the training of healthcare professionals all contribute to the comprehensive approach needed to improve lung cancer screening, diagnosis, and patient outcomes.

Upcoming innovation

To continue providing solutions for clinicians, it is crucial for industry to move away from the model of providing products for healthcare systems; instead, we must provide overall solutions for patients which addresses the entire pathway. These are solutions which can address lung cancer diagnosis but also broader respiratory issues such as COPD, asthma and interstitial lung disease.

Artificial intelligence can provide a route for clinicians to drive forward the quality of screening and diagnosis that patients receive. We know all too well that a lack of capacity in lung cancer screening can cause delays to diagnosis, and early diagnosis is vital to support better patient outcomes. Greater utilisation of innovative artificial intelligence technology can address this to deliver more efficient care. 

Conclusion

While the recovery from the COVID-19 pandemic is ongoing across Europe, the respiratory clinical community has begun to achieve real progress for patients in terms of lung cancer screening pilot schemes and programmes. Industry must continue to provide them with support in terms of the most innovative solutions, as well as raising awareness, especially amongst marginalised communities. Finally, the most significant improvement for patients would be the dismantling of the stigma that is associated with lung cancer, ensuring that patients feel comfortable to come forward for a potential diagnosis. It will be crucial, for us all to stand proudly by the side of the patient community.

[i] https://www.medicalnewstoday.com/articles/lung-cancer-stigma-holds-back-treatment-research; https://www.hindawi.com/journals/jo/2022/2183055/ ; https://bmjopen.bmj.com/content/9/5/e025902

[ii] Quintana Dawson, NELSON trial: reduced lung-cancer mortality with volume CT screening https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30059-X/fulltext

[iii] https://www.brit-thoracic.org.uk/news/2021/future-of-lung-disease-care-at-risk-due-to-workforce-shortages-and-backlog-from-covid-19/