Incidence
About 1.6 million people die from lung cancer every year in the world - in terms of the number of deaths, this cancer is in first place. In second place is liver cancer (745 thousand deaths per year) and stomach cancer (723 thousand). The number of deaths from cancer is 8.2 million, from coronary heart disease - 7.4 million, from stroke - 6.7 million (data from British and American organizations involved in the fight against cancer, 2016)
From 2009 to 2019, the incidence of lung cancer among Russian women increased by 29% and has not yet changed by 2022.
In Russia, in 2018, lung cancer accounts for 15 percent of all deaths from oncology: more than 50 thousand patients a year with an average incidence of 60 thousand[1].
Malignant neoplasms in the trachea, bronchi and lungs account for 21.9% of deaths from cancer. [2]. Despite the treatment methods used before the last in the Russian Federation, within a year from the moment of diagnosis, half of patients still die - 49.6%. The five-year survival rate after diagnosis is 40%.
Non-small cell lung cancer (NSCLC) accounts for 80-85% of the total number of malignant lung tumors. One of the varieties of NSCLC is NSCLC with a T790M mutation in the EGFR gene (epidermal growth factor receptor); in Russia, about 355 patients need to treat this disease annually.
<b
Every year, 1.8 million new cases of lung cancer are diagnosed.
2-13% - average survival over 5 years from lung cancer at stage 4 (non-small cell lung cancer)
58-73% - average survival over 5 years from lung cancer at the 1st stage (non-small cell lung cancer). Data from UK and US cancer organizations, 2016]]
Risk group
Smoking
The reason for the development of the disease is smoking (even e-cigarettes). According to 2018 data, the risk of developing lung cancer in smokers is 20 times higher compared to those who did not make this bad habit.
Malignant tumors of the lung, larynx, pharynx and other cancer, which make up 30% of all deaths as a result of cancer, are caused by tobacco smoke. Professor, Academician of the Russian Academy of Medical Sciences David Zaridze spoke about this in December 2020 during the Forum on Public Health in Minsk.
Smoking, according to the professor, causes 90% of all cases of lung cancer. Even passive smoking is carcinogenic. The main source of carcinogens - resin, is a byproduct of tobacco combustion at high temperature.
Cancer has a high dose dependence on the number of carcinogens entering the body of a smoker with tobacco smoke. People smoke for nicotine, and die because of resins.
Environmental environment
It is impossible to write off the environmental situation, which also affects the development of the disease (say, air pollution). Lung cancer is more common in men than in women. In addition, there is a direct dependence on age: 60-70-year-olds have a significantly higher incidence rate than 30-40-year-olds.
Symptoms
The symptoms of lung cancer in the early stages are rather nonspecific:
- shortness of breath,
- chest pain,
- whistling sounds during breathing,
- chronic dry cough (in the advanced stages - with blood),
- enlarged lymph nodes in supraclavicular region.
Metastases
Diagnostics
2023: Countries that banned smoking in public places saw lung cancer rates drop by 17%
The introduction of legislative bans on smoking in transport and public places in many countries of the world has led to a 17% decrease in the incidence of lung cancer. This is stated in a study by Hitotsubashi University, the results of which were released in early July 2023.
The authors of the report studied 144 works in the relevant field. Scientists combined the results of observations and assessed how the anti-tobacco measures taken affected the health of the population. It is emphasized that the indicators are clearly not related to higher taxes or prices for tobacco products.
The study includes all policies implemented by governments and non-governmental organizations aimed at reducing the number of smokers. Such diseases as asthma, chronic obstructive pulmonary disease, pneumonia, bronchitis spontaneous pneumothorax and lung cancer cardiovascular ailments (acute myocardial infarction, ischemic disease, hearts acute coronary syndrome, sudden arrest of blood circulation), cerebrovascular diseases (, stroke transient ischemic attack), malignant formations , etc.
The researchers found that legislative bans on smoking in offices, public places and in transport increase the general level of public health. On average, they reduced the incidence of cardiovascular and respiratory diseases by 10% and 17%, respectively, and also reduced the mortality rate from these ailments by 10% and 9%. The number of hospitalizations of patients with severe forms of heart and lung disease decreased by 9%. In addition, it is said to reduce the likelihood of adverse perinatal outcomes by 4-9%. The risk of preterm birth is reduced by approximately 10%. Reducing tobacco consumption and overall mortality is positively affected by the ban on cigarette advertising.[3]
2022
The diagnosis of "lung cancer" in St. Petersburg began to be made 17% less often
In 2022, 1549 residents of St. Petersburg were diagnosed with lung cancer, which is slightly more than a year earlier (1534 cases), but significantly - by 17% - less in comparison with 2020. Vadim Pishchik, deputy head physician for surgery of the city clinical oncology dispensary, spoke about this at the end of June 2023.
According to him, the jump in the detection of lung cancer in 2020 (then such a diagnosis was made by more than 1800 patients) occurred due to the "end-to-end" examination of patients with suspected coronavirus (COVID-19) infection by computed tomography.
 | Such a great "help" as COVID-19 gave us patients with accidentally diagnosed cancers. They would come to us in 2-3 years, - explained Pishchik. |  |
At the same time, as the deputy head of the clinical oncology dispensary surgery in St. Petersburg added, there was a whole group of patients who, due to "covid" restrictions, did not reach the doctors.
Evgeny Levchenko, Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Thoracic Oncology, N.N. Petrov, at the end of June 2023 cited data according to which from 2000 to 2021. in St. Petersburg, the number of primary cases of lung cancer decreased among the male population from 1623 to 1417 or 206 cases (by 12.7%), among the female population increased from 390 to 718 by 328 (by 84.1%).
| | Up to 20% of lung cancer cases are women, and many of them have never smoked. And here the absence of smoking in public places, the unequivocal cessation of smoking in children, the tightening of environmental standards that regulate the requirements for the emission of harmful substances in the exhaust gases of cars come to the fore, - said Levchenko. | |
He added that the passage of computed tomography at least once every two years allows you to detect the disease in the early stages and prevent the development of complications.[4]
70% cases of lung cancer in Russia are diagnosed at stages III and IV
The diagnosis of "lung cancer" in Russia in 70% of cases is made when the disease has already reached the third or fourth stage. This was announced in October 2022 by an oncologist at the Center for Thoracic Surgery, GBUZ "Research Institute - Regional Clinical Hospital No. 1 named after Prof. S. V. Ochapovsky "Dmitry Perunov.
According to him, almost 85% of patients suffer from non-small cell lung cancer (NSCLC), and in more than 65% of them the disease manifests itself at the locally advanced or metastatic stage. In 55% of NSCLC cases, at diagnosis, metastases are found in which the relative five-year survival rate is less than 5%. At the same time, about 49% of patients get sick at working age, Perunov noted.
Шаблон:Quote 'We see 18-year-old patients as well, but at this stage the vast majority are people aged 55-65,' he added. Diagnosis of NSCLC is based on history, examination, results of instrumental examination methods and pathomorphological conclusion established on the basis of morphological examination. The appropriate material is obtained by biopsy or aspirate from a primary tumor or metastatic focus.
Dmitry Perunov says that it is necessary to strive to clarify the morphological form of lung cancer using IHC research, since at any stage the options for treating the patient may change.
The doctor also cited statistics that the survival rate of smoking patients is reduced and is 56% compared to 77% in non-smokers. At the same time, the risk of relapses increases, repeated tumors are four times more likely to occur and the likelihood of postoperative mortality increases.
Quitting smoking in lung cancer contributes to improved survival, reduced risk of postoperative complications and side effects of radiotherapy, increased effectiveness of chemotherapy, reduced risk of other smoking-related diseases, and improved quality of life for patients.[5]
"Biocad" patented a test system that helps identify mutations in the EGFR gene and detect lung cancer at an early stage
Researchers of the Russian biotechnological company "Biocad" patentalitest system, which helps to identify mutations in the EGFR gene. With the help of a patented method at the intersection of biotechnology, molecular biology and medicine, it is possible to formulate an effective therapeutic treatment for non-small cell lung cancer. Read more here.
2021
The service "CT of the lungs" learned to detect oncological diseases at an early stage
On October 22, 2021, SberMedII announced the improvement of the Lung CT service. Now artificial intelligence has learned to detect cancer at an early stage when analyzing chest CT scans and can help doctors in diagnosis. Read more here.
A neural network has been created that calculates the likelihood of developing lung cancer from fluorography and CT
At the end of May 2021, it became known about the creation of a neural network that calculates the risk of malignant neoplasms from computed tomography and fluorography images. Kiran Venkadesh from the Institute of Health Sciences at Radbud University (Netherlands) and his colleagues developed an algorithm that evaluates the malignancy of pulmonary nodules found in screening CT . To train the algorithm, 16,077 images of pulmonary nodules (including 1,249 malignant ones) collected during the National Lung Screening between 2002 and 2004 were used. Pulmonary nodules are unusually dense structures measuring three centimeters or less. Usually these are benign neoplasms, but in 20% of cases such CT changes indicate a malignant tumor. Read more here.
Microinvasive cancer can be detected in less than 1% of cases
Tracheobronchial tree cancer is one of the most difficult forms of the disease to diagnose in the early stages. Microinvasive cancer can be detected in less than 1% of cases.
"Due to the lack of changes in the radiograph, tracheobronchial tree cancer is most often detected by chance. Effective diagnostic methods for this form of cancer are narrow spectral bronchoscopy. Improving the effectiveness of diagnostics is impossible without the method of endoscopic examination of the mucous membrane, "said Leonid Cherkes, researcher at the Blokhin National Medical Research Center of Oncology, in March 2021.
Endoscopic signs of cancer in the early stages - the appearance of a small granulomatous type of overgrowth and crimped, dilated vessels. According to Leonid Cherkes, it is precisely because of the late diagnosis that mortality from this form of malignant tumors accounts for more than half of all cases today. According to the oncologist, 42% of all cancers could be prevented by modifying risk factors in time.
2020: Botkin.AI platform helps Moscow doctors detect lung cancer on CT scans
In Moscow, artificial intelligence began to analyze computer tomograms and detect signs of lung cancer on them. This was reported on August 18, 2020 by the Skolkovo Foundation. To do this, the Botkin.AI platform is used, developed by the resident of the Skolkovo Foundation by Intellectodzhik. The service is integrated with the Unified Radiological Information System of Moscow. Read more here.
2018:70% of cases in Russia diagnosed at an advanced stage
Experts advise doing fluorography once a year to detect lung cancer at an early stage. By the way, scientists constantly talk about the early diagnosis of the disease and warn that it is possible to cure cancer at an early stage. In particular, the oncologist surgeon, director of the Eurasian Oncology Federation Somasundaram Subramanian, previously spoke about this:
"If it's too early to identify many types of cancer, they can be cured. In some tumors, almost one hundred percent cure is possible if the disease is detected in the first and second stages. And if we identify it late, then we will not be able to save 15 percent of people. "
For 2018, the statistics are depressing: more than 70 percent of cases in Russia are diagnosed in the late stages.
"In metastatic lung cancer, the five-year survival rate is less than five percent. The fact is that until recently, the possibilities of treatment were limited. Despite the height of the era of targeted therapy, in the overwhelming majority of cases, patients continue to receive the first standard chemotherapy, which has extremely limited effectiveness, "says Konstantin Laktionov, MD, Professor, Head of the Department of Clinical Biotechnology, Deputy Director for Medical Work, FSBI" N.N. Blokhin National Medical Research Center of Oncology "Ministry of Health of the Russian Federation.
2016
Diagnosis of adenocarcinoma and squamous cell lung cancer by AI
In August 2016, the results of medical tests were published, showing the effectiveness of the computer in diagnosing cancer during pathological studies.
A group of specialists from the Stanford Stanford University University Medical Center took more than 2,000 images from the Cancer Genome Atlas, a collection of genetic and clinical materials obtained from several thousand people with cancer. Data on the degree and stage of development of adenocarcinoma and squamous cell carcinoma of the lungs were considered. More. here
New diagnostic methods: low-dose CT, genetic sequencing and respiratory tests
At the end of May 2016, a publication appeared on the Siemens Healthineers website dedicated to one of the most deadly diseases on the planet - lung cancer. The note says that innovative approaches to the diagnosis and treatment of this terrible ailment can help reduce mortality among cancer patients.
Mass screening of lung cancer with low-dose CT scans holds great promise in the field of early diagnosis of this disease. This method, which is safer than traditional chest X-rays, has one important drawback - a high proportion of false positive results.
The National Lung Screening Trial (NLST), in which over 53 thousand heavy smokers from the United States took part, showed that in most cases (96%) the test gave an incorrect positive result for oncology. As a result, you have to resort to additional examinations (more detailed computed tomography, biopsy, positron emission tomography, etc.), which leads to an increase in costs and increases psychological pressure on patients.
To improve the accuracy of screening using computed tomography with a low dose of radiation, as reported in the medical center at the University of California, Los Angeles (UCLA), the largest nodules should be attributed to cancers (previously the minimum diameter was considered 4 mm).
Genetic sequencing and respiratory tests are also proposed for more effective screening in individual patients. Healthy people and cancer patients have been proven to have different metabolisms, and this is reflected in the chemical signature of exhaled air.
In addition, surgical methods of treating tumor diseases are also developing. In particular, work is underway to improve imaging to carry out minimally invasive procedures for the removal of cancerous tissues through small incisions of the chest in the early stages of the disease.[6]
Treatment
2023: Takeda acknowledged the failure of its cancer treatment drug. Now all parties are being recalled around the world
On 2 Oct 2023, the Japanese pharmaceutical company Takeda announced the withdrawal of Exkivity (mobosertinib) for the treatment of non-small cell lung cancer (NSCLC). Tests of the drug did not confirm its effectiveness. Read more here.
2020
MISIS scientists used Indian plant to fight lung cancer
On December 8, 2020, it became known that zinc oxide nanorods that suppress the growth of cancer cells were able to be obtained by scientists at NUST MISIS as part of an international group of researchers. According to experts, the created nanorods are obtained without the participation of toxic substances using an extract from the leaves of a tropical plant. The results of the study are published in the journal JOM. Read more here.
Proton therapy reduces risk of heart disease in lung cancer patients
At the end of October 2020, it became known that proton therapy administered to patients with lung cancer reduces the risk of certain forms of heart disease. In particular, the researchers identified a reduction in the risk of transient ischemic attacks and myocardial infarction over the next two years in this group of patients. Read more here.
Philips Releases Azurion Lung Edition Imaging System for Lung Cancer Diagnosis and Treatment
In late September 2020, Philips Healthcare released the Azurion Lung Edition imaging system designed to diagnose and treat lung cancer. The novelty is a 3D imaging and navigation platform that should speed up and facilitate interventions in lung cancer by combining CT-like 3D images obtained by examination with real-time X-ray inspection and other tools to support procedures on the lungs under visual control. Read more here.
A cure for lung cancer found in Russia
On August 25, 2020, Lomonosov Moscow State University reported the discovery of a possible drug for lung cancer. We are talking about the pharmacological form of vitamin B1 - cocarboxylase, which is widely used in medicine for diabetes, renal and heart failure. According to scientists, cocarboxylase in high doses can have a negative effect on lung cancer cells without affecting healthy ones.
It is reported that the protein molecule tripeptide glutathione enhances the resistance of malignant tumors to chemo- and radiotherapy. This molecule has a lot of functions aimed at improving cell viability, especially under harmful effects. Scientists found that increased glutathione in lung cancer cells is associated with low activity of the polyenzyme complex oxoglutarate dehydrogenase (OGDA). Hence, it was suggested that activation of 2-oxoglutarate dehydrogenase would reduce the concentration of glutathione and, accordingly, the ability of cancer cells to multiply.
To test their idea, scientists of Moscow State University. M.V. Lomonosov conducted an in vitro experiment on human lung cancer cells and normal epithelial (the disease affects them) monkey cells.
According to the project manager for the RNF grant, Doctor of Chemical Sciences, leading researcher in the biokinetics department of the Belozersky Research Institute of Physicochemical Biology, Moscow State University Victoria Bunik, clinical studies of this action of cocarboxylase will now be required. New data on the anti-cancer effects of high doses of cocarboxylase and their safety for normal cells may have medical applications in the treatment of lung cancer, especially in combination with other agents, she said.[7]
Oncologists in Kemerovo performed a unique operation on the patient's lungs
In July 2020, doctors at the Kemerovo Clinical Oncological Dispensary performed a unique operation on the patient's lungs - microwave thermal ablation of the tumor, using the Covidien Emprint device, which was purchased as part of the national Healthcare project. Read more here.
Mortality
2020: The number of deaths from respiratory cancer in the Russian Federation over 10 years decreased by 15%
The number of deaths from respiratory cancer in Russia over 10 years has decreased by 15%. This is stated in an article by the scientific journal Lancet Respiratory Medicine, published in August 2021. Read more here.
2018: Women's lung cancer deaths to rise by half by 2030
On August 1, 2018, a study was published in the Journal of the American Association for Cancer Research, according to which mortality rates from lung cancer in women between 2015 and 2030 will increase by almost half - by 43%. Researchers suggest more women will die of lung cancer than breast cancer by the end of this period.
The use of computed tomography at a low dose of radiation (LDCT) to screen for lung cancer reduces the mortality rate by 20%, but this examination method is not used as effectively as its potential allows, said a team of researchers led by Juan Carlos Martín-Sánchez, professor at the International University of Catalonia in Barcelona (Spain).
Lung cancer deaths have already surpassed breast cancer deaths in several countries, according to the study authors. In fact, breast cancer deaths (age-standardized) are projected to decline by 9% from 2015 to 2030, while lung cancer deaths will increase.
Previous studies have shown that prevention and treatment of breast cancer has led to a clear decrease in mortality rates. Historically, lung cancer incidence per 100,000 women has been lower than breast cancer incidence - from 0.8 in equatorial Africa to 33.8 in North America - but the five-year survival rate for this disease is very low - less than 20% in developed countries. Since 60% of deaths in lung cancer in women are associated with smoking, mortality varies depending on the level of tobacco consumption in different regions.
Martin-Sanchez and colleagues used information from the 2008-2014 WHO mortality database to estimate deaths from lung cancer and breast cancer in women worldwide. The team assessed lung and breast cancer deaths by country, year and age group of patients in 52 countries. They compared current mortality rates (age-standardized) with the projected mortality rate for both diseases and established that by 2030, more women would die from lung cancer: if in 2015 lung cancer deaths were 11.2 cases per 100,000 women and breast cancer deaths were 16.1, then the predicted mortality values in 2030 are 16 and 14.7 cases, respectively.
By 2030, lung cancer deaths in women will be higher than breast cancer in 26 of the 52 countries analyzed, the researchers report, with 24 belonging to a group of countries with high per capita GNP - apparently due to the wider prevalence of tobacco smoking in those countries.
For prevention, LDCT can be used to screen for lung cancer, however, its implementation is still limited despite recommendations from the U.S. Preventive Services Task Force. Some experts attribute this to low compensation from the national health insurance fund, some - lack of awareness of patients and doctors about the existence of such a research method.
Lung cancer screening programs could be implemented in the near future, which would subsequently reduce projected mortality rates, the researchers note. In the meantime, CT screening is not available, the efforts of specialists should be aimed at preventing smoking in women and helping smokers to combat this addiction, since this is the main risk factor for lung cancer.[8]
2015: Reduced mortality in men and growth in women
1985: How did the USSR manage to reduce lung cancer mortality if the proportion of smokers was only growing?
The direct link between smoking and cancer has been proven by numerous studies. World statistics show that a decrease in the proportion of smokers leads to a pronounced decrease in deaths from lung cancer and laryngeal cancer. However, in Russia, the decline in mortality from these diseases began in the mid-1990s just when cigarette sales began to grow rapidly.
The proportion of smokers peaked in 2009, but deaths from cancers caused by smoking have been steadily declining for more than a decade. What explains the Russian statistical anomaly, in June 2020, the famous Russian oncologist, president of the Anti-Cancer Society of Russia, visiting professor at Oxford University David Zaridze spoke in one of the lectures held as part of the Scientific and Educational Program of the Anti-Cancer Society of Russia.
Studies proving a direct relationship between rising lung cancer rates and smoking emerged in the early 1950s. Later it became known that smoking leads to an increased risk of developing malignant tumors of other organs. The scientific community was forced to admit that this common habit leads to dangerous oncological diseases. The translation of this knowledge in society, the active promotion of smoking cessation led to a steady decrease in the popularity of this habit among the population of developed countries, which naturally led to a decrease in mortality from many forms of cancer. As an illustration, Professor Zaridze suggests looking at data on deaths from malignant tumours associated with smoking among men aged 35 to 69 in the UK. Since the early 1970s, by 2005, this figure has decreased by more than 2.5 times, while mortality from other forms of cancer has remained approximately the same.
Another situation was developing in Russia. Cigarette sales grew steadily and peaked in the mid-2000s. If in the early 1990s, according to official data, more than 200 billion cigarettes were sold in the country per year, then by the beginning of the 2010s more than 400 billion cigarettes were sold in Russia per year. This explosive rise in cigarette sales would seem to have been followed by an increase in deaths from lung cancer and other smoking-associated tumors. However, statistics do not record this. Although until the early 1990s in the RSFSR and Russia, mortality from lung cancer among men steadily increased. However, then a steady decline began, although smoking became no less, and even more. In other countries, deaths from smoking-associated cancers have generally declined following a decrease in cigarette consumption. In Russia, with a sharp increase in cigarette consumption, mortality from lung cancer declined. Moreover, similar dynamics were demonstrated by statistics for others cancer related to, smoking such as laryngeal cancer. A similar dynamic, however less pronounced, was observed among women.
In 2009, the prevalence of smoking reached a historic maximum - 60% of men and 22% of women smoked. However, lung cancer deaths declined from 1993 to 2016 by 40%. How to explain such a Russian anomaly?
As David Zaridze said, this is the merit of scientists. In 1985, the International Conference "Tobacco is the Main International Threat to Health" was held in Moscow at the Cancer Research Center under the auspices of the International Agency for the Study of Cancer. The recommendations of this conference gave rise to the prevention of smoking in the USSR and Russia. According to Professor Zaridze, the list of recommendations was huge, but the key role in reducing mortality was not they, but an additional measure - to introduce an upper limit for the content of resins in tobacco smoke to 15 mg per cigarette. At that time, the tar content in cigarettes sold in the USSR was not regulated in any way. As a result, it reached extremely high rates - 30 mg or more per cigarette. Most of the carcinogenic substances are in the resin. The state listened to the recommendations of doctors and in 1988 the Ministry of Health of the USSR introduced MPC for the content of tar in cigarettes - no more than 15 mg/whitefish. According to Zaridze, this led to a decrease in morbidity and mortality from lung cancer since 1993 and saved more than 400 thousand lives in Russia alone.
In fact, this decision was nothing new. Back in the mid-1970s, British psychiatrist and active anti-smoking fighter Professor Michael Russell formulated the concept of smoking harm reduction (Tobacco Harm Reduction). He was the first to formulate the main problem, saying that people smoke for nicotine, and die because of resins. Later, the British Richard Doll and Richard Peto explained the decrease in mortality from lung cancer in young British men by switching to filtered cigarettes, which were passed into the lungs much less resins, and therefore carcinogenic substances.
See also
Notes
- ↑ Immunotherapy: experts talked about universal weapons in the fight against oncology
- ↑ M.V. Avksentiev et al. Assessment of the socio-economic burden of lung cancer in the Russian Federation Medical technologists: assessment and choice of DOI:10.31556/2219-0678.2018.34.4.063-075;
- ↑ Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes
- ↑ How to prevent a lung cancer pandemic, told St. Petersburg oncologists
- ↑ About 70% cases of lung cancer in Russia are diagnosed at stages III and IV
- ↑ The Future of Lung Cancer Diagnosis and Treatment
- ↑ Scientists have named a vitamin that contributes to the suppression of lung cancer cells
- ↑ Global lung cancer death rates for women to increase
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