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44IN PREVENTION AND SCREENING
Lung Cancer 64 Suppl. 1 (2009) S24
Prevention and screening 44IN PREVENTION AND SCREENING G. Ostoros1 , R. van Klaveren2 1 Orsz´ agos Kor´ anyi Tbc e ´s Pulmonol´ ogiai Int´ ezet, Budapest, Hungary, 2 Department of Pulmonology, Erasmus University Medical Center, Rotterdam, Netherlands Lung cancer (LC) is the most preventable cancer type among solid tumors. Its main risk factor is smoking. Approximately 90% of male and 70% of female patients are smoker. However, there are some non-pharmacological and some pharmacological smoking cessation therapies. Nicotine replacement therapy (gum, patch, nasal spray, inhalator, sublingual tablet, and lozenge) and other pharmacological treatments (antidepressants, anxiolytics, nicotine receptor blockers and vaccines) can help the patients giving up smoking. The long term exposure of second and the newly described “third hand” smoke enhances the LC risk as well. The radon, asbestos, nickel, cooling oil vapor, air pollution and genetic predisposition are the other main risk factors. The changing face of LC (identification of new molecular markers and having more never smokers, women and
0169-5002/$
see front matter © 2009 Elsevier Ireland Ltd.
adenocarcinomas) is becoming a new challenge in the fight against LC. Effective screening for any cancer requires the development of a comprehensive multidisciplinary clinical team of key professionals who interact with the participants in the screening program starting with the initial contact to the communication of the results, further diagnostic workup and treatment. It also requires an optimal regimen of screening which defines the initial CT scan parameters, the definition of a positive result and the workup algorithm leading to the diagnosis of the cancer. Drawback of CT screening is the large number of nodules detected and the high rate of testpositives. In NELSON a positive test result and subsequent work-up for diagnosis is based on the size of new nodules and the volume doubling time (VDT) of previously existing nodules. VDT assessment in NELSON has replaced the role of the fine needle aspirates, evaluation after antibiotics and positron-emission tomography for the work-up of suspicious nodules. NELSON. In the NELSON screen strategy the number of follow-up scans has been limited to only one per screening round. Based on this novel strategy will increase acceptance of CT screening for potential mass screening purposes.
Prevention and screening 44IN PREVENTION AND SCREENING G. Ostoros1 , R. van Klaveren2 1 Orsz´ agos Kor´ anyi Tbc e ´s Pulmonol´ ogiai Int´ ezet, Budapest, Hungary, 2 Department of Pulmonology, Erasmus University Medical Center, Rotterdam, Netherlands Lung cancer (LC) is the most preventable cancer type among solid tumors. Its main risk factor is smoking. Approximately 90% of male and 70% of female patients are smoker. However, there are some non-pharmacological and some pharmacological smoking cessation therapies. Nicotine replacement therapy (gum, patch, nasal spray, inhalator, sublingual tablet, and lozenge) and other pharmacological treatments (antidepressants, anxiolytics, nicotine receptor blockers and vaccines) can help the patients giving up smoking. The long term exposure of second and the newly described “third hand” smoke enhances the LC risk as well. The radon, asbestos, nickel, cooling oil vapor, air pollution and genetic predisposition are the other main risk factors. The changing face of LC (identification of new molecular markers and having more never smokers, women and
0169-5002/$
see front matter © 2009 Elsevier Ireland Ltd.
adenocarcinomas) is becoming a new challenge in the fight against LC. Effective screening for any cancer requires the development of a comprehensive multidisciplinary clinical team of key professionals who interact with the participants in the screening program starting with the initial contact to the communication of the results, further diagnostic workup and treatment. It also requires an optimal regimen of screening which defines the initial CT scan parameters, the definition of a positive result and the workup algorithm leading to the diagnosis of the cancer. Drawback of CT screening is the large number of nodules detected and the high rate of testpositives. In NELSON a positive test result and subsequent work-up for diagnosis is based on the size of new nodules and the volume doubling time (VDT) of previously existing nodules. VDT assessment in NELSON has replaced the role of the fine needle aspirates, evaluation after antibiotics and positron-emission tomography for the work-up of suspicious nodules. NELSON. In the NELSON screen strategy the number of follow-up scans has been limited to only one per screening round. Based on this novel strategy will increase acceptance of CT screening for potential mass screening purposes.