Clinical and Economic Problem of Lung Cancer
Lung cancer kills more than 1.34 million people worldwide each year, and is the leading cause of cancer deaths in the industrialized world. Deaths from this disease exceed deaths from breast, colon, ovarian, and prostate cancer combined. More than 220,000 new cases of lung and bronchial cancer were diagnosed in the United States in 2010. The five-year survival rate for lung cancer is 16%, compared with breast and prostate cancers, which have five-year survival rates greater than 90%. This is due in large part to the difficulty of diagnosing lung cancer at an early stage. Small tumors that have not metastasized are seldom found using current diagnostic methodologies, e.g., bronchoscopy, scanning techniques, and needle biopsies.
Early diagnosis of lung cancer has been identified as a key strategy for improving prospects for survival; however, 65-80% of lung cancer patients present with late-stage disease. Only 15% of all lung cancer patients are diagnosed with localized disease. Among patients with localized tumors no more than 3 cm in diameter, the five-year survival rate is 53%, and higher survival rates have been observed in tumors diagnosed while still smaller. Consequently, diagnosis of small tumors (currently difficult to access with bronchosopy) is of paramount importance to increasing long-term survival.
Lung cancer results in significant costs to the health system. According to a 2007 Harvard economic analysis, the annual cost of treating early-stage lung cancer is approximately $120,000, compared with $1.2 million for treating advanced disease. As many as 20% of all patients referred for lung cancer surgery do not have lung cancer, causing an unnecessary cost burden to the healthcare system as well as unnecessary risk to the patient. Patients who are not referred for surgical intervention require monitoring with serial CT scans, resulting in significant cost to the healthcare system and radiation exposure to the patient.