A UBC-led team has demonstrated that a prediction tool developed by Canadian researchers to detect early-stage lung cancer in high-risk individuals is significantly more accurate than other leading models, suggesting that the team’s innovative approach could be used in screening programs around the world.
Lung cancer is the most common cause of cancer death around the world – yet if caught early enough it can be cured in 70 per cent of cases, making early detection a critical feature in a predictive model.
Stephen Lam
The Pan Can Lung Cancer Risk Prediction Model – which is used to determine if a person should undergo annual computed tomography (CT) screening to detect early-stage lung cancer – outperformed comparable models such as The National Lung Screening Trial, which is led by the U.S. National Cancer Institute. The Pan Can Model was developed in part by Professor of Medicine Stephen Lam, with $8.4-million support from the Terry Fox Research Institute (TFRI) and The Canadian Partnership Against Cancer.
Currently, both the U.S. and Canadian lung cancer screening guidelines are based on age and smoking history. But the Pan Can Model also looks at numerous additional variables: sex, family history of lung cancer, chronic obstructive pulmonary disease, educational level and body mass index.
The PanCan Model diagnosed lung cancer in 6.5 per cent of people screened with a follow-up of five years, compared to the 4 per cent of cases found by the National Lung Screening Trial over a longer term (6.5 years). Further, 77 per cent of the lung tumours diagnosed with the Pan Can Model were caught in early-stages when the cancer is potentially curable, compared to 57 per cent in the NLST study.
The results, highlighted in a study published Oct. 18 in The Lancet Oncology, were presented at the World Conference on Lung Cancer in Yokohama, Japan that same day by Dr. Lam, Chair of British Columbia’s Provincial Lung Tumour Group at the BC Cancer Agency.
“We knew our Pan Can Lung Cancer Risk Prediction Model would probably work better than other models, but we were surprised at how much better,” Dr. Lam says. “We have the means to identify high-risk people, and we know we can find cancer early. This model provides a superior tool that would be beneficial in Canada and around the world in saving more lives.”
“Looking at just age and smoking history is actually a very inaccurate way of doing things, because we know that age and smoking history alone finds 33 per cent fewer people with lung cancer than the PanCan prediction tool,” adds Dr. Lam.
Ottawa resident Debi Lascelle took part in the Terry Fox Research Institute study, and credits the early-detection protocol with catching her cancer while it was still curable.
“Being involved in this study quite literally saved my life,” said Lascelle, who had a 13-milimetre tumour removed from her right lung through surgery and has been cancer-free ever since. “How do you adequately find a way to say, ‘Thank you for my life’? It’s been seven years and I still haven’t found a way.”
The TFRI Pan-Canadian Early Lung Cancer Detection Study was expanded in 2017 to examine factors such as genetics and air pollution in lung cancer risk. The study is looking to recruit 2,000 British Columbians who have smoked for at least 20 years and are between 55 and 80.