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Sebastian Schmidt: Declining mortality in lung cancer – a beacon of hope

Photo taken from Sebastian Schmidt/LinkedIn

Nov 1, 2023, 14:55

Sebastian Schmidt: Declining mortality in lung cancer – a beacon of hope

Sebastian Schmidt, Head of Strategy and Medical Affairs Computed Tomography at Siemens Healthineers, posted on LinkedIn:

“Declining mortality in lung cancer – a beacon of hope.

I made a little chart for my presentation at the European Society of Thoracic Imaging (ESTI) conference in Berlin today that I wanted to share with you.

The chart shows an analysis of the US cancer statistics (SEER data). The orange line is the incidence per 100k inhabitants (cases of lung cancer), scale on the left. The black line is lung cancer mortality (deaths from lung cancer). The grey bars are the Mortality/Incidence ratio, which gives an estimate of what percentage of patients die from the disease.

What do we see:

– Mortality and incidence were largely parallel over a longer time (actually longer than the period shown here). The Mortality/Incidence ratio therefore almost constantly >80%, little to no improvement. Consider this is a time period when we saw enormous improvements in breast cancer and many other cancers.
– Late 90s, incidence started to go down. This is surely an effect of the tobacco control measures introduced in the 70s. Tobacco control works, but of course with a 20-year latency. Mortality still parallel. MIR above 80%.
– Around 2014, the MIR started declining – mortality went down faster than incidence. This is a sign that survival of patient finally improves, after so many years of little change.

Two effects likely have contributed: New drugs, mainly immuno-oncological, improved survival. And the USPSTF recommended lung screening, the screening programs started, which increased the share of early-stage diagnosis.

Could overdiagnosis play a role? Rather unlikely – the typical sign for large-scale overdiagnosis in screening programs is increasing incidence with constant mortality. We don’t see increasing incidence here – the curve declines evenly, following the reduction in smoking 20 years earlier. And the mortality is obviously declining.

This is positive news and should encourage more countries to take up lung cancer screening. ”

Sebastian Schmidt: Declining mortality in lung cancer - a beacon of hope

Source: Sebastian Schmidt/LinkedIn