Diagnosis and treatment of early lung cancer

Lung cancer is the leading cause of cancer death in Australia. Recently there have been unparalleled advances in the screening and management of lung cancer.

The aim of this article is to discuss diagnosis and management of lung cancer, including advances that are likely to translate into future practice.

Screening with low-dose computed tomography scans has proven to be effective for detecting early curable disease, reducing mortality by ≥20% in randomised controlled trials. Implementation trials are underway within Australia and overseas, and a Commonwealth Inquiry is ongoing. Breath and blood biomarkers are less invasive alternatives that show potential but remain under investigation. Early diagnosis of lung cancer is key to improving survival - this includes familiarity with nodule screening recommendations and facilitating access to early tissue diagnosis via transthoracic needle aspiration or bronchoscopy. Treatment decisions can then be guided by staging with scans, molecular testing and multidisciplinary team consideration in the frame of patient factors/preferences. The therapeutic armamentarium is boosted by an increasing range of effective therapies including modern surgical and radiation techniques, and systemic treatments including targeted therapies and immunotherapy.