In 2020, approximately 41,000 new lung cancer diagnoses were estimated in Italy (27,550 men and 13,300 women). THEn six years (2015-2021) the mortality rate decreased by 15.6% in men but increased by 5% in women. The 5-year survival data is 16% in men and 23% in women. Epidemiological analyzes deliver one new photograph of the pathology, which is becoming more and more feminine. If lung cancer advances into the pink universe, however, it is this half of the sky that could benefit most from lung screening with low-dose CT.
Are there any differences between men and women? “Screening works in both genders“, said Ugo Pastorino, director of thoracic surgery of the Irccs National Cancer Institute (Int) of Milan, today in the Lombard capital during the presentation of the ‘Italian manifesto PolmoniAMO‘, made with the support of AstraZeneca, an initiative that aims to raise awareness among citizens and institutions on the importance of early diagnosis. But “all the data seem to show that, while the incidence of smoking and age is similar between men and women, mortality is much lower in women screened than in men. There is a greater benefit. It is not clear why this happens but it is revealed by all the studies, even in Italy we have the same evidence that in women the advantage is greater. This opens up other possibilities. For example, in women who smoke, CT could be proposed as a combined screening together with mammography and I think this could be a winning strategy in the short term “.
In general on the front of the fight against cancer i crucial points there are two: early diagnosis and prevention, lists Daniela Galeone, Directorate-General for Health Prevention of the Ministry of Health. “The National Prevention Plan 2020-2025 invests heavily in cancer prevention both through inter-sectoral health promotion actions (healthy nutrition, physical activity, abstention from the use of cigarettes and other tobacco products and from the harmful and risky consumption of alcohol ), and through the improvement of participation in oncological screenings provided by the NHS, whose offer and adhesion can be considered a protective factor for mortality and morbidity due to the three oncological pathologies currently subject to screening (cervical, breast and colon cancer rectum) “.
For Galeone it is “also important increase the supply of tobacco cessation interventions, monitoring the possible appearance of symptoms in former smokers considering the latency times between exposure and the onset of smoking-related cancer “. The Resp-Rete Italian lung screening program,” activated thanks to the Ministerial Decree of November 8, 2021, is aimed at experimenting an intervention lung cancer prevention and monitoring “with low dose chest computed tomography (Ldct),” to evaluate the feasibility of personalized early diagnosis programs in high-risk populations in the Italian context. The support activity for the cessation of smoking will be fundamental, actively offered to all the subjects recruited and monitored in the results “.
He is also tuttoranother pilot project is underway that goes in the same direction, coordinated by the Tuscany Region “through the Institute for the study, prevention and oncology network-Ispro, where the National Screening Observatory (Ons) is also operational. The connection between the two initiatives represents an added value for an evaluation of the results of the two studies in order to identify a possible model of organized population screening “. The biggest investment, adds Pastorino,” is prevention. Diagnosis must be associated with true prevention. Lung screening is an educational moment in which we can help, in which a contact of trust is established “.
And it is “sustainable”, highlights the expert: “We think we can save resources that today are destined for the ineffective treatment of metastatic disease, with an early treatment that is faster, more effective, occurs many years earlier and can intercept this demand for expensive and ineffective therapies. So in the long run it is an investment “. And, says Giorgio Vittorio Scagliotti, director of the Division of Medical Oncology at the University of Turin, “it brings people back to civil and working life, which unfortunately is penalized in the treatment of advanced disease”.