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Lung Cancer Screening Dramatically Increases Long-term Survival Rate

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November 22, 2022 — Diagnosing early-stage lung cancer with low-dose CT screening drastically improves the long-term survival rate of cancer patients, according to a large-scale, 20-year international study being presented next week at the annual meeting of the Radiological Society of North America (RSNA).

“While screening doesn’t prevent cancers from occurring, it is an important tool in identifying lung cancers in their early stage when they can be surgically removed,” said the study’s lead author, Claudia Henschke, Ph.D., M.D., professor of radiology and director of the Early Lung and Cardiac Action Program at the Icahn School of Medicine at Mount Sinai in New York.

Lung cancer is the leading cause of cancer death. According to the American Lung Association, the average lung cancer five-year survival rate is 18.6 percent. Only 16 percent of lung cancers are diagnosed at an early stage, and more than half of people with lung cancer die within one year of being diagnosed.

While treatments of more advanced-stage cancers with targeted therapy and immunotherapy have come a long way, the best tool in the fight against cancer deaths is early diagnosis through low-dose CT screening before symptoms appear.

“Symptoms occur mainly in late-stage lung cancer,” Dr. Henschke said. “Thus, the best way to find early-stage lung cancer is by enrolling in an annual screening program.”

Dr. Henschke and colleagues have been studying the effectiveness of cancer detection with low-dose CT screening for years. The efforts of the researchers to advance CT screening for early lung disease led to the creation of the International Early Lung Cancer Action Program (I-ELCAP). Started in 1992, this multi-institution, multi-national research program has enrolled over 87,000 participants from over 80 institutions.

In 2006, the researchers identified a 10-year survival rate of 80% for the patients whose cancer was identified by CT screening. For this study, they looked at 20-year survival rates.

“What we present here is the 20-year follow-up on participants in our screening program that were diagnosed with lung cancer and subsequently treated,” Dr. Henschke said. “The key finding is that even after this long a time interval they are not dying of their lung cancer.”

The study found that the 20-year survival rate was 80% for the 1,285 I-ELCAP participants who were diagnosed with early-stage lung cancer. The survival rate for both the 139 participants with nonsolid cancerous lung nodules and the 155 participants with nodules of part-solid consistency was 100%. For the 991 participants with solid nodules, the survival rate was 73%.

The researchers also estimated survival for clinical Stage IA lung cancers and for resected pathologic stage IA lung cancers measuring 10mm or less in average diameter of length and width on the same CT image. A stage I lung cancer is a very small tumor that has not spread to any lymph nodes.

Lung cancer survival for clinical Stage IA participants was 86%, regardless of consistency. For participants with pathologic Stage IA cancers of 10 mm or less, the 20-year survival rate was 92%.

The results show that after 20 years, patients diagnosed with lung cancer at an early stage via CT screening have significantly better outcomes. By surgically removing the cancer when it is small enough, patients can be effectively cured in the long term.

The findings demonstrate the importance of routine and early screening.

“Ultimately, anyone interested in being screened needs to know that if they are unfortunate enough to develop lung cancer, that it can be cured if found early,” Dr. Henschke said.

The U.S. Preventive Services Task Force recommends annual lung cancer screening with low-dose CT in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.

Co-authors are David F. Yankelevitz, M.D., Daniel M. Libby, James Smith, M.D., Mark Pasmantier, M.D., and Rowena Yip, M.P.H.

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Some Ontario docs now offering RSV shot to infants with Quebec rollout set for Nov.

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Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.

The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.

Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.

Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.

Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.

The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.

This report by The Canadian Press was first published Oct. 21, 2024.

-With files from Nicole Ireland

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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Polio is rising in Pakistan ahead of a new vaccination campaign

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ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.

Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.

The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.

Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.

Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.

The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.

Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.

The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.

Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.

The Canadian Press. All rights reserved.

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White House says health insurance needs to fully cover condoms, other over-the-counter birth control

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WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.

Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.

The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.

“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”

The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”

Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.

If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.

Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.

The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.

The Canadian Press. All rights reserved.

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