Lung Cancer: Detection and innovations in lung cancer screening

Basic overview of lung cancer: Risk factors, cancer types, and screening

The Lung Cancer Detection Test-1 (LCDT1) uses a proprietary algorithm in conjunction with 21 protein biomarkers to detect early-stage NSCLC with 95.6% accuracy, sensitivity of 89.1% and a specificity of 97.7%, making it a perfect test to complement the existing lung cancer screening methods.

What is lung cancer?

As discussed in our previous blog post that provides a basic overview of the lung cancer, lung cancer is a type of cancer that originates in the lungs. It is one of the most common types of cancer and is currently the leading cause of cancer death in the U.S. In fact, according to American Cancer Society, lung cancer is the second most common cancer in both men and women in the United States (not including skin cancer).

Lung cancer can be divided into two main types: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is less aggressive when compared to SCLC, but it is important to detect NSCLC early so that it does not spread to nearby tissues. Generally, about 10 to 15% of all lung cancer cases are SCLC, and about 80 to 85% of lung cancer cases are NSCLC.

Lifetime chance of getting lung cancer (Statistics from American cancer Society)

What is the difference between cancer screening and cancer diagnosis?

As a proactive measure, cancer screening involves evaluating individuals who do not display any symptoms of cancer. Its primary goal is to detect cancer at an early stage, increasing the chances of successful treatment.

On the other hand, cancer diagnosis is performed when symptoms arise, and it usually follows a screening procedure that may have revealed potential indications of cancer.

Lung cancer screening

Lung cancer screening is used to detect lung cancer in people who exhibit no symptoms or signs of lung cancer but are deemed  high risk for lung cancer. Currently, the only recommended screening test for lung cancer is low-dose computed tomography (low dose-CT scan or LDCT). According to American Lung Association, based on early-stage lung cancer stats, if lung cancer is detected before it spreads, it improves likelihood of surviving 5 years or more by 60%.

Who should be screened for lung cancer?

The U.S. Preventive Services Task Force (USPSTF) recommends yearly screening for lung cancer with LDCT for people who:

      • Are between 50 to 80 years old, and
      • Have 20 pack-year smoking history*, and
      • Currently smoke or have quit within the past 15 years.

*A pack-year is equal to smoking an average of one pack of cigarettes per day for one year.

It is important to find out if you meet the high-risk criteria for lung cancer screening. Talk to your healthcare provider or doctor about your eligibility for screening. This decision could be made based on your age, smoking history, family history and other additional factors.

What is low-dose computerized tomography or low-dose CT scan?

A low-dose CT scan is a special type of X-ray that emits low dose of radiation. This imaging process captures multiple images of the patient’s lungs as they comfortably lie down on a table that moves in and out of a machine. These images, taken from different angles, are then pieced together to create a comprehensive 3-D view of lungs. Nodules or other lung abnormalities may then be detected in these images.

CT scan imaging

What to expect during and after the lung cancer scan?

Your lung cancer screening center should be able to provide more information on how to prepare for the scan. They may ask you to remove any metal accessories that you might be wearing.

The scan itself is quick and takes only about 2 minutes. However, the examination could last for approximately 15 minutes. The scan is painless and the technician can walk you through the whole process. The scanner may make some noise and the table may be moved for a better view of the organ. You may be asked to lie still and hold your breath for a few seconds. After the scan, you should be able to move around normally and go about your regular activities. After a thoracic radiologist reads your scans, your doctor will notify you of your results and set up any necessary follow-ups if needed.

How long should the screening be continued?

In general, lung cancer screening can be stopped once a person has not smoked for 15 years or if they have a health problem that could prevent them from receiving lung cancer treatment. If it is deemed that the person is unlikely to benefit from screening, their physician may discontinue screening.

Advantages and risks of lung cancer screening

The National Lung Screening Trial (NLST) compared LDCT scan and standard chest X-ray for detection of lung cancer. It found that annual screening with LDCT for three years was better at finding early-stage lung cancer compared to chest x-rays. Annual LDCT screening also decreased the risk of dying from lung cancer in high-risk patients.

While LDCT is the current gold standard in lung cancer screening, it also comes with a few possible risks, including:

False positive test results: The test could suggest that a person has lung cancer even if there is no cancer present. This could result in unnecessary invasive follow-up tests such as biopsy, and anxiety in patients.

Overdiagnosis: Lung cancer screening tests may find cancerous nodules that may have never caused a problem for the patient. This overdiagnosis may lead to unnecessary treatments.

Exposure to radiation: Repeated LDCT or X-ray tests increases exposure to radiation that can cause cancer.

Always talk to your healthcare provider regarding your risks for lung cancer and whether a screening test is right for you. It is important to know the risks of the screening tests before undergoing the test.

Did You Know?

TargetDx Laboratory’s Lung Cancer Diagnostic Test 1 (LCDT1) technology uses proprietary machine learning algorithm, which when combined with patient demographic data and biomarker values, generates a result of High Risk (Positive) or Low Risk (Negative) for early-stage NSCLC diagnosis.

Blood tests for lung cancer detection

Currently, there are no FDA approved blood tests that can detect lung cancer. However, there are few blood tests that the doctor could order to help assess the patient’s general health and determine eligibility for surgery. These blood tests may include:

Complete Blood Count (CBC)

This blood test is used to evaluate the quantities of various types of blood cells in the patient’s blood. It can identify anemia, risk of bleeding or infections by detecting a low number of red blood cells, platelets, or white blood cells, respectively. The test may need to be repeated periodically during the cancer treatment course.

Blood chemistry tests

These tests could be used to check whether the patient’s kidneys or liver are functioning normally.

Some of the other most common tests that you may come across would be tissue biopsy and liquid biopsy.

Tissue Biopsy

A specialist removes a small amount of tissue from a potentially cancerous area. The tissue sample is then sent to a laboratory where it is examined by a pathologist under a microscope for the presence of cancer cells.

Liquid Biopsy

Sometimes, there may not be enough tissue for examination or it may not be possible to get a tissue biopsy done. In such cases, liquid biopsies may be advised by doctors. A liquid biopsy detects DNA from cancer cells circulating in the blood, called ‘circulating tumor DNA’ or ‘ctDNA’.  It is performed by a simple blood draw and the blood sample is then sent to a laboratory for analysis.

The healthcare practitioner may also opt to use both tissue and liquid biopsy to support the initial diagnosis and help guide the treatment plan.

Biomarkers and Proteomics

A rising focus in cancer diagnostics is on biomarkers. Biomarkers are indicators found in blood or other body fluids that describe the condition of the body, and they can reflect the normal or abnormal biological processes. These could be various types of molecules found in your body, such as DNA, proteins, etc. Since these characteristics can be measured, anything from blood pressure to specific proteins produced by tumors can be considered a biomarker. Finding effective biomarkers can simplify the diagnostics process for many diseases.

When researchers look at protein biomarkers, they analyze the different proteins produced in a living organism. This study is called proteomics. Proteins are produced from genes throughout the body. They can give insight into how the body is reacting to diseases or conditions. Unlike genes (or DNA), proteins reflect the live interaction between genes and the environment.

Because of recent advances in proteomics, scientists are now able to learn more from protein behavior. They can recognize patterns and identify certain proteins that point towards diseases like lung cancer, asthma, and COPD, and develop diagnostic tests to detect these diseases. Since proteins can be studied from a tissue sample, they could allow a much less invasive and clearer path to diagnosis. Proteomics are also used for identifying specific tumor properties, determining the cancer stage, or shaping cancer treatment strategies. In 2009, TargetDx Laboratory published a study identifying 21 biomarkers that strongly correlate to lung cancer. This discovery led us to develop our blood test, LCDT1, to detect early-stage lung cancer.

Lung Cancer Detection Test-1 (LCDT1)

More and more companies are researching how blood tests could help detect lung cancer TargetDx Laboratory developed a simple blood test known as the Lung Cancer Detection Test-1 (LCDT1) which detects early-stage Non-Small Cell Lung Cancer (NSCLC). The LCDT1 uses a proprietary algorithm in conjunction with 21 protein biomarkers to detect early-stage NSCLC with 95.6% accuracy, sensitivity of 89.1% and a specificity of 97.7%, according to a recent study published in BMC Cancer. The test’s high accuracy makes it a perfect test to complement the existing lung cancer screening methods.

The test is designed as an adjunctive test and should not be used without an independent clinical/radiological evaluation. The LCDT-1 is not intended to be a screening test or to determine whether a patient should proceed with surgery.

LCDT-1 has not been cleared or approved by the U.S. Food and Drug Administration. Rx only.

The test is developed as an LDT (laboratory developed test), exclusively intended for use by TargetDx Laboratory, and is expected to be available by the end of 2023.

Upon the launch of LCDT1 test, your doctor can order the test if they suspect that you may have lung cancer. You will get your blood drawn at the hospital lab. The plasma is separated, shipped overnight to our CLIA-certified laboratory, where it is evaluated for 21 biomarkers. The results of these biomarkers in conjunction with our proprietary algorithm will provide a high risk (positive) or low risk (negative) result for NSCLC. The test result will be sent to your doctor who will discuss your results with you.