|Period from:||2008-10-01 to 2013-09-30|
|Drs. Stephen Lam and Ming Tsao|
|Co-Investigators:||Annette McWilliams; John Mayo; Stuart Peacock; Richard Finley; John Yee; Ken Evans; Don Sin; Wan Tan; Alain Tremblay; Paul Burrowes; Paul MacEachern; Martin Tammemagi; Heidi Roberts; Frances Shepherd; Geoffrey Liu; Kam Sophrati; John Thenganatt; Natasha Leighl; John Goffin; Serge Puksa; Lori Stewart; Bill Evans; Garth Nicholas; Glen Goss; Jean M Seely; Kayvan Amjadi; Simon Martel; Francis Laberge; Michel Gingras; Michael Johnston; Daria Manos|
|Institution:||British Columbia Cancer Agency|
|Partner:||Canadian Partnership Against Cancer Corporation|
|Program:||Biomarker Research Project|
Currently, lung cancer is the most common cause of cancer death in Canada, accounting for 11,000 and 8,900 cancer deaths in men and women respectively. Worldwide, over 1.2 million people die of lung cancer each year. By 2020, it is projected that lung cancer will be the fifth highest killer among all diseases. Even with the best of health care, overall, only 16% of lung cancer patients survive five years or more. However, if lung cancer is diagnosed and treated early (Stage 0/IA), the five-year survival is over 77%. Thus, early detection and treatment of lung cancer is the most promising strategy to reduce lung cancer mortality.
The overall goal of this project is to develop a new multi-modal screening strategy that integrates risk modeling, autofluorescence bronchoscopy (AFB) and serum biomarkers with low-dose spiral computed tomography (CT) for early detection of lung cancer.
We hypothesize that the inclusion of low-cost risk modeling and biomarkers to select population cohorts with the highest risk of lung cancer development can provide a cost-effective application of relatively expensive, yet effective, detection methods. This could render lung cancer screening an affordable program within the Canadian health care system. Using short-term outcomes from this study, including detection rates and costs, we shall be able to compare our results with other existing programs, including those of the major randomized trials in the United States and Europe, and provide an informed decision for the implementation of lung cancer screening in Canada.
If validated in this study, our multi-modal risk assessment model estimates that approximately 15 highest risk subjects will need to be screened to find one lung cancer, instead of the current ratio of over 40:1, using age and smoking as enrolment criteria.
If in the future a Canada-wide lung cancer screening program is desired, this study will provide the specialized professional expertise to ensure its implementation. For example, population penetration strategies for large-scale screening will have been developed. Radiologists skilled in interpretation of lung cancer screening CT scans, biopsy and localization of small lung nodules, chest physicians skilled in performing AFB and surgeons familiar with minimally invasive resection and treatment methods will be available.
If the randomized trials outside of Canada are positive, expansion of provincially based early detection programs across Canada will benefit the general population similar to that achieved in cervical and breast cancer screening.
A very recent report by the Milken Institute (October 2007, www.chronicdiseaseimpact.com) on the impact of major chronic disease in the age group in which lung cancer is prevalent projected huge social and economic benefits from preventing loss of human capital.