KEY TAKEAWAYS
- The study aimed to identify the most efficient and cost-effective early detection method for clinical practice in patients with lung cancer.
- The results showed that while LDCT remains the standard, combining it with new methods may reduce false positives.
Lung cancer has the highest mortality rate among malignancies globally, and there is considerable concern about its growth due to the increasing number of smokers. Early detection is an essential step toward reducing complications related to lung cancer, as it helps ensure the most effective treatment, lowers healthcare costs, and increases survival rates.
Nour Kenaan and the team aimed to define the most efficient and cost-effective method of early detection in clinical practice.
Researchers collected information for this review by searching PUBMED for papers published between 2021 and 2024, focusing primarily on systematic reviews, meta-analyses, and clinical trials. They also included older but notable papers deemed essential for understanding the topic.
The results demonstrated that EB-OCT had varied sensitivity and specificity, averaging 94.3% and 89.9%, respectively. In contrast, detecting biomarkers via liquid biopsy showed an average sensitivity of 91.4% for RNA molecule detection and 97% for combined methylated DNA panels.
Additionally, circulating tumor cell (CTC) detection did not prove effective as a screening method due to the rarity of CTCs in the bloodstream, requiring larger blood samples and enrichment techniques.
They noted that while LDCT remains the current gold standard for screening, it has a high false positive rate. In comparison, endobronchial optical coherence tomography (EB-OCT) has demonstrated a significant advantage with its accuracy in distinguishing between subtypes of non-small cell lung cancer (NSCLC).
Additionally, various biomarkers, including RNA molecules, CTCs, and methylated DNA, have been examined in the literature. Many of these biomarkers exhibit high sensitivity and specificity, positioning them as potential candidates for future early detection strategies.
The study concluded that while LDCT remains the gold standard and the only recommended screening procedure due to its high sensitivity, specificity, and proven cost-effectiveness, notable false positive results raise concerns. This situation prompts researchers to explore improved screening methods, particularly with advancements in artificial intelligence or by combining LDCT with other approaches, such as liquid biopsy, in well-studied screening programs. They recommended to conduct more clinical studies involving larger populations with clear demographic targets and adopting strategies to integrate these new methods with LDCT to reduce false positive cases in early detection.
No funding was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/39300939/
Kenaan N, Hanna G, Sardini M, et al. (2024). “Advances in early detection of non-small cell lung cancer: A comprehensive review.” Cancer Med. 2024;13(18):e70156. doi:10.1002/cam4.70156
