Lung Cancer Screenings: Early Detection Matters

There’s an easy and safe screening for lung cancer that is saving lives, often catching disease at an early stage before symptoms appear. Yet sadly, lung cancer is still the leading cause of cancer death in the U.S.

Physicians at Baptist Health Miami Cancer Institute are trying to change that, in part by finding new ways to reach out to the region’s at-risk populations and educate people about the importance of screening.

Recently, Manmeet Ahluwalia, M.D., deputy director, chief of medical oncology and chief scientific officer at Miami Cancer Institute — as well as Fernandez Family Foundation Endowed Chair in Cancer Research — sat down with Upal Basu Roy, Ph.D., MPH, executive director of LUNGevity Research. The LUNGevity Foundation is a non-profit organization focused on lung cancer research and patient advocacy.

Manmeet Ahluwalia, M.D., deputy director, chief of medical oncology, chief scientific officer and Fernandez Family Foundation Endowed Chair in Cancer Research at Baptist Health Miami Cancer Institute

In the podcast, Dr. Ahluwalia and Dr. Basu Roy discussed advances in care, how the collaboration between the Institute and LUNGevity has already increased lung cancer screenings in Hispanics and what a similar partnership between the organization and primary care providers can accomplish.

Dr. Basu Roy said that, despite an uptick in lung cancer screenings and a change in the screening guidelines, nationally only about 4.5 percent of those eligible are screened. “In the State of Florida, it’s even lower, with about 2.4 percent of people who are eligible for lung cancer screening actually receiving screening,” he says.

Why Hispanics are encouraged to get lung cancer screenings

Despite the fact that Miami Cancer Institute serves a region whose population is more than two-thirds Hispanic, only 40 to 42 percent of lung cancer screening patients at the Institute are Hispanic, according to Dr. Ahluwalia.

“Minorities tend to screen at a lower rate compared to the White population, which is why Baptist Health partnered with LUNGevity in establishing the nation’s first Hispanic lung cancer screening program,” says Dr. Ahluwalia.

He says the number of lung screenings at Miami Cancer Institute has nearly doubled over the past several years as a result of the partnership with LUNGevity. “A pivotal piece of our partnership has been ensuring that we have screening education materials and awareness campaigns in Spanish to meet the needs of the community.”

The strategy seems to be working. “We used to see less than 2,000 patients a year at the Institute for lung cancer screenings,” Dr. Ahluwalia says. “By year’s end, we hope to have screened close to 4,000 patients in 2024.”

Who should get screened for lung cancer?

Dr. Basu Roy notes that lung cancer screenings are available for people between the ages of 50 and 80, as well as anyone with a history of tobacco use or exposure. “Lung cancer screening is typically available for patients who have at least a 20-pack year of tobacco exposure, meaning they smoked one pack a day for the last 20 years or two packs a day for the last 10 years,” he explains. Screening is also available for those who are either current tobacco users or have quit within the past 15 years.

Unfortunately, says Dr. Ahluwalia, most lung cancer patients are diagnosed late, when they already have locally advanced disease or metastatic disease. “The outcomes of these patients is only around 20 to 25 percent survival at five years, compared to 60 to 65 percent survival at five years in patients who are diagnosed with early-stage disease that we can actually surgically remove.”

Why should I consider genetic testing?

Dr. Basu Roy says that when he started at LUNGevity, “we had just one targeted therapy approved for lung cancer for one type of mutation, the EGFR mutation.” EGFR is epidermal growth factor receptor, a protein located on the surface of cells that helps them grow. A mutation in the gene that codes for the EGFR protein can make cells grow too much, which can cause cancer.

“Today we have targeted therapies for nine different molecular biomarkers and these are targetable mutations,” Dr. Basu Roy continues. “Molecular testing is so important because that’s the only way to identify if the tumor has a targetable biomarker, which can ensure that the patient gets matched to the right treatment at the right time.”

The EGFR mutation is more prevalent in Hispanic patients compared to Caucasians, says Dr. Ahluwalia, which underscores the importance of screening for Hispanics. “In Hispanics, 40 to 50 percent have the mutation. In White Caucasian patients, it’s only around 10 to 15 percent.”

Two years ago, the pivotal ADAURA clinical trial suggested that if you use one of the targeted EGFR drugs, osimertinib, for early-stage lung cancer and give it to patients after they’ve had surgery as an adjuvant treatment, then it dramatically increases the cure rates. “That’s why testing for these biomarkers and finding early-stage disease is critically important,” Dr. Ahluwalia says.

Targeted therapies like osimertinib can also extend the lives of EGFR lung cancer patients, he adds. “Even those who have metastatic disease, if treated with chemotherapy, outcomes are around 12 months,” says Dr. Ahluwalia. “But, if you start using targeted therapies, the outcomes are 38 to 39 months. And patients can tolerate these targeted therapies much better than chemotherapy.”

For more information on lung cancer screenings at Baptist Health, click here. During November, which is Lung Cancer Awareness Month, Baptist Health is offering lung cancer screenings to patients who meet the criteria for $35. For information, click here.