According to WebMD, lung cancer causes the most cancer-related deaths for both men and women worldwide. The American Cancer Society reported 228,190 new lung cancer cases of and 159,480 deaths in 2013. While tobacco smoking has been cited as the chief cause and cessation programs have been effective, lung cancer remains the most common form of cancer and the fifth most common cancer in women worldwide, as well as the leading cause of cancer-related deaths in American women (http://www.webmd.com/lung-cancer/guide/lung-cancer-statistics#0).
Furthermore, lung cancer, which is responsible for the most cancer deaths in the United States, will kill 158,000 people in 2015, more than breast, prostate, and colon cancer combined, according to the National Cancer Institute, according to "Less invasive test for lung cancer expected in 2016," an article posted on Futurity. The article explains that the quick growth and spread of lung cancer prompt many healthy and former smokers to undergo diagnostic screening CT scans of the chest, which can detect small lung lesions in the lungs that could be an early sign of lung cancer. Because abnormal results can lead to painful and invasive biopsies, researchers have found a better diagnostic tool (http://www.futurity.org/lung-cancer-diagnostics-biomarkers-928562/).
As reported in the New England Journal of Medicine, Avrum Spira, professor of medicine, pathology, and laboratory medicine and bioinformatics at Boston University, has achieved good clinical trial results on a molecular test to detect lung cancer early but without invasive biopsies. This month, a new, noninvasive test for the disease called Percepta, based on biomarkers developed by Spira and his collaborators Jerome Brody, professor of medicine, and Marc Lenburg, associate professor of medicine, was released by the molecular diagnostics company Veracyte. As Spira, a pulmonologist at Boston Medical Center, said, "It's a growing problem in our clinical pulmonary practices: smokers, either current or former, have something abnormal found on a CT scan of the chest, and we're worried it might be lung cancer."
Doctors have several tools available for followup. A minimally invasive bronchoscopy may not always find small tumors buried deep in the lung. A lung biopsy, often an invasive and expensive procedure, comes back negative one-third of the time.
Using the Percepta test at the same time as a bronchoscopy, the doctor uses a small brush to sample normal-looking cells in the upper airway and sends the sample to a lab for genetic testing. These cells, while appearing healthy, are in the "field of injury" damaged by cigarette smoke and contain 23 genomic markers that demonstrate "a high likelihood of cancer elsewhere in the lung" -- protective genes being turned off or genes associated with cell growth being turned on. By finding them, clinicians can catch or rule out lung cancer.
The test was validated in two clinical trials, involving 639 patients at 28 sites in the United States, Canada and Ireland. It identified 97 percent of the lung cancers, compared to 75 percent for bronchoscopy alone. It is not widely available or covered by insurance, but if the early access program in a limited number of medical centers is successful, the test could be made widely available in early 2016.
