Diagnosis in Primary Care

The Nurse Practitioner • January 2007 43 ung cancer is currently the most fatal malignancy in the world. More individuals die from lung cancer than breast, colorectal, and prostate cancers combined. And because of poor survival rates, the incidence of lung cancer mimics its mortality rates. The 5-year survival rate for lung cancer remains a grim 14%, and 90% of lung cancer patients eventually succumb to the disease. Early detection of lung cancer in the primary care setting is a challenge in the absence of mass screening guidelines. According to the U.S. Preventive Services Task Force (USPSTF), there is insufficient evidence to either refute or recommend screening for lung cancer in asymptomatic patients (including the use of chest X-ray, sputum cytology, and low-dose computerized tomography [CT]). Lung cancer is challenging to treat unless found in its early stage— the majority of patients do not exhibit symptoms until the cancer has metastasized. This is crucial to the excessive mortality rate of lung cancer. Nurse practitioners should be knowledgeable about risk factors, pathophysiology, and presenting symptoms. Familiarity with current evidence-based research regarding the roles of genetics and estrogen in the development of this disL Diagnosis in Primary Care