Urgent focus on lung cancer is needed to avoid trillion-dollar costs

Dave Fredrickson, executive vice president of AstraZeneca’s Oncology Business Unit, shares his views on improving outcomes in lung cancer following the World Conference on Lung Cancer.

Lung cancer is the leading cause of cancer mortality worldwide and accounts for the greatest economic and public health burden of all cancers. While governments, the life sciences industry, and the oncology community have recognized this burden and made significant efforts to reduce it, progress in lung cancer survival rates haven’t kept pace with some other types of cancer. In addition to the human impact of cancer, it has a staggering economic effect. Between 2020 and 2050, cancer is expected to cost the world economy $25.2 trillion. Of all cancer types, lung cancer–related costs account for the highest burden at 15.4% or $3.9 trillion. 

Our ambition at AstraZeneca is to have a medicine for more than one-half of all people treated for lung cancer by 2030, and that commitment goes beyond just delivering effective medicines. We’re reimagining the patient experience for the future by driving early diagnosis, advancing precision medicine, and helping to ensure that people with cancer can achieve the best outcomes. Eliminating lung cancer as a cause of death will require working together across the public and private sectors to prioritize early detection, leverage new technology, and invest in health care systems for the long term.

At the 2023 World Conference on Lung Cancer (WCLC), the largest forum on lung cancer, health care providers, researchers, scientists, advocates, and life sciences companies met in Singapore to share the latest, ground-breaking data and discuss improving lung cancer outcomes across the globe. Here are some of my key takeaways as I reflect on the multi-stakeholder meetings I attended. And why, despite the difficult reality of the disease, I remain optimistic for the future of lung cancer treatment.  

With millions of lives at stake, it is time to urgently take action. 

1. Increase investment in screening and early diagnosis

Detecting lung cancer in its early stages is one of the most effective ways to improve survival outcomes and reduce health care costs. A 2020 study in the U.S. found that the difference early detection can make is dramatic: If patients are diagnosed in early stages when cancer is localized, lung cancer has an almost 60% five-year survival rate. In advanced stages, that number plummets to 8%. 

Additionally, early-stage lung cancer can be managed with less complex and less expensive treatment compared to later stages, creating significant cost savings for the health care system. Today, only around one in five patients with lung cancer is lucky enough to be diagnosed at Stage I. The other four in five patients miss a chance at early diagnosis due to many factors, including lack of awareness of symptoms, low rates of screening in high-risk populations, and under-resourced health systems. 

Prioritizing investment in robust lung cancer screening programs as part of national cancer control plans could transform outcomes. A 2022 study in more than 1 million Chinese residents showed a one-off low-dose computed tomography (LDCT) scan of high-risk individuals lowered lung cancer mortality by 31%, compared with non-screened participants. Another study in a high-risk population in Europe found that the adoption of targeted screening with LDCT scans led to a substantial shift toward diagnosis at earlier stages, where chance for curative treatment is highest. With increasing awareness of these potential benefits, governments in Australia, the European Union, Taiwan, and the U.K. have all recently committed to expanding access to lung cancer screening. 

In addition to national efforts, partnerships across the public and private sectors are needed to maximize impact. For example, in Singapore, we’ve partnered with Singapore’s Ministry of Health as part of the Healthier SG initiative to support programs to train general practitioners to recognize signs and symptoms of lung cancer and to make the necessary referrals to ensure timely diagnosis and treatment. 

Expanding the scope of lung cancer screening initiatives worldwide and ensuring high-risk populations take advantage of available programs would have a huge impact on shifting diagnosis to earlier stages of disease. WCLC also reminded me that the treatment options for patients in early stages keep expanding at a rapid pace. 

2. Accelerate the application of A.I. and new technologies 

Every industry is grappling with the promise of artificial intelligence (A.I.) and how best to integrate it into their work. We’re already seeing signs of the transformative impact that A.I. can have in health. In lung cancer, doctors rely on complex images, such as X-rays, MRIs, and CT scans, to diagnose patients and monitor progress. Generative A.I. technology can analyze the data from these images faster and with more precision than the human eye and could accelerate the process of detecting lung cancer. Importantly, A.I. analysis can be used on any type of scans available, which makes it applicable to many health care settings with varied resources. 

For example, in several countries where X-rays are predominantly used, AstraZeneca has partnered with Qure.ai to analyze X-rays for potential early-stage lung cancers using A.I. This initiative integrates the technology into routine chest X-rays and existing screening programs to improve the detection of lung cancer quickly and at scale. In Europe, where CT scans are more common, AstraZeneca has partnered with Aidence to provide A.I. software solutions to 30 hospitals across Europe, helping to increase diagnosis of lung cancer at earlier stages through better detection and the follow-up of incidental pulmonary nodules that can sometimes be cancerous.

So far, we have only scratched the surface. The opportunity to rapidly integrate A.I. into lung cancer diagnosis and treatment pathways across the globe is immense, and it will require strategic partnerships across the health care system, providers, and governments to fully realize the potential. 

3. Collaborate to build sustainable and resilient health systems

Sustainable health care for all requires investment in strengthening health systems to deliver an infrastructure designed to be responsive to the needs of the population it serves. Supporting lung cancer screening programs and early diagnosis and providing the right balance of incentives to support innovation helps ensure patients have access to the best care. These are critical investments in the sustainability and resilience of health systems, which form the foundation of healthy societies and economies. 

As part of the Lung Ambition Alliance (LAA), a coalition established by leading organizations with deep roots in lung cancer, including AstraZeneca, we have been working to bridge the gap between the commercial and nonprofit sectors with the goal of one day eliminating lung cancer as a cause of death. One focus has been driving collective urgent action to transform outcomes in lung cancer and improve the sustainability of health systems in partnership with the World Economic Forum. 

One of the initiative’s reports offers clear recommendations for governments to target investment in lung cancer to drive earlier diagnosis and better treatment to help improve the chances of survival. The LAA has also published reviews of the clinical and cost effectiveness evidence for lung cancer screening in targeted populations using LDCT scans to highlight the high cost to patients and society of inaction on screening.

Significant progress against lung cancer—or indeed any disease—will ultimately come when society demands an investment in health care and not just sick care.

Despite the challenges of detecting and treating lung cancer early, the blueprints of change are evident in collaborations across research, early detection, and A.I. being forged every day. 

With a wealth of knowledge and support available, the challenge is to identify where new partnerships among companies, providers, nonprofits, and governments can help bridge gaps to find new ways to deliver earlier intervention and treatment to the right patient at the right time. This includes public support for research and policies that foster more private sector investment. 

The cost of inaction on lung cancer remains high, and countless lives depend on prioritizing this public health need. 

Note: This article was supplied by AstraZeneca.