Top

Published in:

Open Access 01-12-2023 | Lung Cancer | Opinion

Ten reasons to screen women at risk of lung cancer

Authors: Marie-Pierre Revel, Guillaume Chassagnon

Published in: Insights into Imaging | Issue 1/2023

Abstract

This opinion piece reviews major reasons for promoting lung cancer screening in at-risk women who are smokers or ex-smokers, from the age of 50. The epidemiology of lung cancer in European women is extremely worrying, with lung cancer mortality expected to surpass breast cancer mortality in most European countries. There are conflicting data as to whether women are at increased risk of developing lung cancer compared to men who have a similar tobacco exposure. The sharp increase in the incidence of lung cancer in women exceeds the increase in their smoking exposure which is in favor of greater susceptibility. Lung and breast cancer screening could be carried out simultaneously, as the screening ages largely coincide. In addition, lung cancer screening could be carried out every 2 years, as is the case for breast cancer screening, if the baseline CT scan is negative.

As well as detecting early curable lung cancer, screening can also detect coronary heart disease and osteoporosis induced by smoking. This enables preventive measures to be taken in addition to smoking cessation assistance, to reduce morbidity and mortality in the female population.

Key points

• The epidemiology of lung cancer in European women is very worrying.

• Lung cancer is becoming the leading cause of cancer mortality in European women.

• Women benefit greatly from screening in terms of reduced risk of death from lung cancer.

Ferlay J, Colombet M, Soerjomataram I et al (2019) Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 144:1941–1953. https://doi.org/10.1002/ijc.31937CrossRefPubMed

Montagne F, Guisier F, Venissac N, Baste J-M (2021) The role of surgery in lung cancer treatment: present indications and future perspectives—state of the art. Cancers 13:3711. https://doi.org/10.3390/cancers13153711CrossRefPubMedPubMedCentral

Potter AL, Rosenstein AL, Kiang MV et al (2022) Association of computed tomography screening with lung cancer stage shift and survival in the United States: quasi-experimental study. BMJ 376:e069008. https://doi.org/10.1136/bmj-2021-069008CrossRefPubMedPubMedCentral

The National Lung Screening Trial Research Team (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409. https://doi.org/10.1056/NEJMoa1102873CrossRefPubMedCentral

de Koning HJ, van der Aalst CM, de Jong PA et al (2020) Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med 382:503–513. https://doi.org/10.1056/NEJMoa1911793CrossRefPubMed

Pastorino U, Silva M, Sestini S et al (2019) Prolonged lung cancer screening reduced 10-year mortality in the MILD trial: new confirmation of lung cancer screening efficacy. Ann Oncol 30:1672. https://doi.org/10.1093/annonc/mdz169CrossRefPubMedPubMedCentral

Becker N, Motsch E, Trotter A et al (2020) Lung cancer mortality reduction by LDCT screening—results from the randomized German LUSI trial. Int J Cancer 146:1503–1513. https://doi.org/10.1002/ijc.32486CrossRefPubMed

Council of the European Union (2022) A new approach on cancer screening (Council recommendation). Available at https://www.europarl.europa.eu/legislative-train/carriage/cancer-screening/report?sid=7201

Levi F, Bosetti C, Fernandez E et al (2007) Trends in lung cancer among young European women: the rising epidemic in France and Spain. Int J Cancer 121:462–465. https://doi.org/10.1002/ijc.22694CrossRefPubMed

10.

Fidler-Benaoudia MM, Torre LA, Bray F et al (2020) Lung cancer incidence in young women vs. young men: a systematic analysis in 40 countries. Int J Cancer 147:811–819. https://doi.org/10.1002/ijc.32809CrossRefPubMed

11.

Luo G, Zhang Y, Etxeberria J et al (2023) Projections of lung cancer incidence by 2035 in 40 countries worldwide: population-based study. JMIR Public Health Surveill 9:e43651. https://doi.org/10.2196/43651CrossRefPubMedPubMedCentral

12.

Carioli G, Malvezzi M, Bertuccio P et al (2021) European cancer mortality predictions for the year 2021 with focus on pancreatic and female lung cancer. Ann Oncol 32:478–487. https://doi.org/10.1016/j.annonc.2021.01.006CrossRefPubMed

13.

Martín-Sánchez JC, Lunet N, González-Marrón A et al (2018) Projections in breast and lung cancer mortality among women: a Bayesian analysis of 52 countries worldwide. Can Res 78:4436–4442. https://doi.org/10.1158/0008-5472.CAN-18-0187CrossRef

14.

Malvezzi M, Santucci C, Boffetta P et al (2023) European cancer mortality predictions for the year 2023 with focus on lung cancer. Ann Oncol 34:410–419. https://doi.org/10.1016/j.annonc.2023.01.010CrossRefPubMed

15.

Zang EA, Wynder EL (1996) Differences in lung cancer risk between men and women: examination of the evidence. J Natl Cancer Inst 88:183–192. https://doi.org/10.1093/jnci/88.3-4.183CrossRefPubMed

16.

Risch HA, Howe GR, Jain M et al (1993) Are female smokers at higher risk for lung cancer than male smokers? Am J Epidemiol 138:281–293. https://doi.org/10.1093/oxfordjournals.aje.a116857CrossRefPubMed

17.

Kreuzer M, Boffetta P, Whitley E et al (2000) Gender differences in lung cancer risk by smoking: a multicentre case–control study in Germany and Italy. Br J Cancer 82:227–233. https://doi.org/10.1054/bjoc.1999.0904CrossRefPubMed

18.

Yu Y, Liu H, Zheng S et al (2014) Gender susceptibility for cigarette smoking-attributable lung cancer: a systematic review and meta-analysis. Lung Cancer 85:351–360. https://doi.org/10.1016/j.lungcan.2014.07.004CrossRefPubMed

19.

Revel M-P, Abdoul H, chassagnon G, et al (2022) Lung CAncer SCreening in French women using low-dose CT and Artificial intelligence for DEtection: the CASCADE study protocol. BMJ Open 12:e067263. https://doi.org/10.1136/bmjopen-2022-067263CrossRefPubMedPubMedCentral

20.

Puliti D, Picozzi G, Gorini G et al (2022) Gender effect in the ITALUNG screening trial. A comparison with UKLS and other trials. Lancet Reg Health Eur 13:100300. https://doi.org/10.1016/j.lanepe.2021.100300CrossRefPubMedPubMedCentral

21.

Bonney A, Malouf R, Marchal C et al (2022) Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality. Cochrane Database Syst Rev 8:2022. https://doi.org/10.1002/14651858.CD013829.pub2CrossRef

22.

Field JK, Vulkan D, Davies MPA et al (2021) Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis. Lancet Reg Health Eur. 10:100179. https://doi.org/10.1016/j.lanepe.2021.100179CrossRefPubMedPubMedCentral

23.

Infante M, Cavuto S, Lutman FR et al (2015) Long-term follow-up results of the DANTE trial, a randomized study of lung cancer screening with spiral computed tomography. Am J Respir Crit Care Med 191:1166–1175. https://doi.org/10.1164/rccm.201408-1475OCCrossRefPubMed

24.

Infante M, Lutman FR, Cavuto S et al (2008) Lung cancer screening with spiral CT. Lung Cancer 59:355–363. https://doi.org/10.1016/j.lungcan.2007.08.040CrossRefPubMed

25.

Blanchon T, Bréchot J-M, Grenier PA et al (2007) Baseline results of the Depiscan study: a French randomized pilot trial of lung cancer screening comparing low dose CT scan (LDCT) and chest X-ray (CXR). Lung Cancer 58:50–58. https://doi.org/10.1016/j.lungcan.2007.05.009CrossRefPubMed

26.

Pastorino U, Sverzellati N, Sestini S et al (2019) Ten-year results of the Multicentric Italian Lung Detection trial demonstrate the safety and efficacy of biennial lung cancer screening. Eur J Cancer 118:142–148. https://doi.org/10.1016/j.ejca.2019.06.009CrossRefPubMedPubMedCentral

27.

Pedersen JH, Ashraf H, Dirksen A et al (2009) The Danish Randomized Lung Cancer CT Screening Trial—overall design and results of the prevalence round. J Thorac Oncol 4:608–614. https://doi.org/10.1097/JTO.0b013e3181a0d98fCrossRefPubMed

28.

Ashraf H, Saghir Z, Dirksen A et al (2014) Smoking habits in the randomised Danish lung cancer screening trial with low-dose CT: final results after a 5-year screening programme. Thorax 69:574–579. https://doi.org/10.1136/thoraxjnl-2013-203849CrossRefPubMed

29.

Brain K, Carter B, Lifford KJ et al (2017) Impact of low-dose CT screening on smoking cessation among high-risk participants in the UK Lung Cancer Screening Trial. Thorax 72:912–918. https://doi.org/10.1136/thoraxjnl-2016-209690CrossRefPubMed

30.

McNeill A, Guignard R, Beck F et al (2015) Understanding increases in smoking prevalence: case study from France in comparison with England 2000–10: France England smoking case study. Addiction 110:392–400. https://doi.org/10.1111/add.12789CrossRefPubMed

31.

Pasquereau anne PRÉVALENCE NATIONALE ET RÉGIONALE DU TABAGISME EN FRANCE EN 2021 PARMI LES 18–75 ANS, D’APRÈS LE BAROMÈTRE DE SANTÉ PUBLIQUE FRANCE. Available at https://www.santepubliquefrance.fr/content/download/498976/document_file/577073_spf00004322.pdf?version=1

32.

Pinsky P (2018) Lung cancer screening with low-dose CT: a world-wide view. Transl Lung Cancer Res 7:234–242. https://doi.org/10.21037/tlcr.2018.05.12CrossRefPubMedPubMedCentral

33.

US Preventive Services Task Force, Krist AH, Davidson KW et al (2021) Screening for lung cancer: US preventive services task force recommendation statement. JAMA 325:962. https://doi.org/10.1001/jama.2021.1117CrossRef

34.

Ren W, Chen M, Qiao Y, Zhao F (2022) Global guidelines for breast cancer screening: a systematic review. The Breast 64:85–99. https://doi.org/10.1016/j.breast.2022.04.003CrossRefPubMedPubMedCentral

35.

Montes U, Seijo LM, Campo A et al (2007) Factors determining early adherence to a lung cancer screening protocol. Eur Respir J 30:532–537. https://doi.org/10.1183/09031936.00143206CrossRefPubMed

36.

Sakoda LC, Rivera MP, Zhang J et al (2021) Patterns and factors associated with adherence to lung cancer screening in diverse practice settings. JAMA Netw Open 4:e218559. https://doi.org/10.1001/jamanetworkopen.2021.8559CrossRefPubMedPubMedCentral

37.

Duong DK, Shariff-Marco S, Cheng I et al (2017) Patient and primary care provider attitudes and adherence towards lung cancer screening at an academic medical center. Prev Med Rep 6:17–22. https://doi.org/10.1016/j.pmedr.2017.01.012CrossRefPubMedPubMedCentral

38.

Zulueta JJ, Montes U, del Ocón M, M, Seijo LM, (2021) Early adherence to lung cancer screening. Annals ATS 18:733–733. https://doi.org/10.1513/AnnalsATS.202009-1188LECrossRef

39.

Management of osteoporosis in postmenopausal women: the, (2021) position statement of The North American Menopause Society. Menopause 28:973–997. https://doi.org/10.1097/GME.0000000000001831CrossRef

40.

Buckens CF, van der Graaf Y, Verkooijen HM et al (2015) Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality. Eur Radiol 25:132–139. https://doi.org/10.1007/s00330-014-3361-0CrossRefPubMed

41.

Pan Y, Shi D, Wang H et al (2020) Automatic opportunistic osteoporosis screening using low-dose chest computed tomography scans obtained for lung cancer screening. Eur Radiol 30:4107–4116. https://doi.org/10.1007/s00330-020-06679-yCrossRefPubMedPubMedCentral

42.

Chen Y-C, Li Y-T, Kuo P-C et al (2023) Automatic segmentation and radiomic texture analysis for osteoporosis screening using chest low-dose computed tomography. Eur Radiol. https://doi.org/10.1007/s00330-023-09421-6CrossRefPubMedPubMedCentral

43.

Mosca L, Manson JE, Sutherland SE et al (1997) Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Circulation 96:2468–2482. https://doi.org/10.1161/01.CIR.96.7.2468CrossRefPubMed

44.

Berman DS, Arnson Y, Rozanski A (2016) Coronary artery calcium scanning. JACC Cardiovasc Imaging 9:1417–1419. https://doi.org/10.1016/j.jcmg.2016.05.020CrossRefPubMed

45.

Kim YK, Sung YM, Cho SH et al (2014) Reliability analysis of visual ranking of coronary artery calcification on low-dose CT of the thorax for lung cancer screening: comparison with ECG-gated calcium scoring CT. Int J Cardiovasc Imaging 30:81–87. https://doi.org/10.1007/s10554-014-0507-8CrossRefPubMed

46.

Shemesh J, Henschke CI, Shaham D et al (2010) Ordinal scoring of coronary artery calcifications on low-dose CT scans of the chest is predictive of death from cardiovascular disease. Radiology 257:541–548. https://doi.org/10.1148/radiol.10100383CrossRefPubMed

47.

Diederichsen A, Lindholt JS, Møller JE et al (2022) Sex Differences in factors associated with progression of aortic valve calcification in the general population. Circ Cardiovasc Imaging 15:e013165. https://doi.org/10.1161/CIRCIMAGING.121.013165CrossRefPubMed

Title: Ten reasons to screen women at risk of lung cancer
Authors: Marie-Pierre Revel
Guillaume Chassagnon
Publication date: 01-12-2023
Publisher: Springer Vienna
Keywords: Lung Cancer
Lung Cancer
Lung Cancer
Breast Cancer
Breast Cancer
Osteoporosis
Osteoporosis
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01512-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ten reasons to screen women at risk of lung cancer

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2023

Reply to the Letter to the Editor referring to “Dual-energy CT for the detection of skull base invasion in nasopharyngeal carcinoma: comparison of simulated single-energy CT and MRI”

A multicenter study of artificial intelligence-aided software for detecting visible clinically significant prostate cancer on mpMRI

AI-based detection of contrast-enhancing MRI lesions in patients with multiple sclerosis

An interpretable MRI-based radiomics model predicting the prognosis of high-intensity focused ultrasound ablation of uterine fibroids

CheckList for EvaluAtion of Radiomics research (CLEAR): a step-by-step reporting guideline for authors and reviewers endorsed by ESR and EuSoMII

Why mild contrast medium-induced reactions are sometimes over-treated and moderate/severe reactions of internal organs are undertreated: a summary based on RadioComics