Early Diagnosis Amd Intervention Lung Cancer: Clinical Studies

Lung cancer is the most common fatal malignancy in both men and women in the United Stares. In 1999, an estimated 171,600 patients will be diagnosed. Because the diagnosis is most commonly made in later stages, including presentations that manifest as distant metastasis, approximately 158,900 deaths will occur in 1999, if the current survival statistics continue. Today, lung cancer is the third most common cause of death in the world. Worldwide, lung cancer was responsible for more than 900,000 deaths in 1990.' Studies examining the efficacy of screening for lung cancer carried out in the 1970s and 1980s have led to a nihilistic attitude regarding the early diagnosis of lung cancer. Easily obtained clinical indices chat can be used to identify individuals at high risk for the development of lung cancer were not appreciated at the time of design of the large screening trials. Unfortunately, these trials were carried out in populations char are not at greatly increased risk for lung cancer and may have yielded falsely discouraging results. The purpose of this chapter is to present an approach to early identification and intervention that could dramatically alter the course and outcome of lung cancer today.