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Lung Cancer: Screening before it's too late

Recognized for its expertise in the field of lung cancer, the McGill University Health Centre (MUHC) is one of eight hospitals designated by the Ministère de la Santé et des Services sociaux (MSSS) to participate in the deployment of a vast lung cancer screening project using low-dose computed tomography (CT scans).

Launched by the MSSS on May 31, this project aims to recruit 3,000 patients across the province who are current or former smokers, aged 55 to 74. The use of CT scans in screening has been shown to reduce mortality.

Dr. Kevin Schwartzman, respirologist and director of the Respiratory Division at the MUHC, says that very often, because of a lack of symptoms, lung cancer cases are diagnosed late: "Unfortunately, by the time the patient has symptoms, the lung cancer is often quite advanced. Many lung cancers that are now found early are discovered by accident, on scans done for other reasons. It's not like a lump under the skin, which is easier to detect, or a cancer that we can detect on a blood test, which is why the targeted lung cancer screening project is so important and can increase the chances of survival. "

Statistics show that when lung cancer is diagnosed early at stage 1 or 2, 80% of patients survive 5 years. Unfortunately, identified at stage 4, the percentage drops dramatically with, at best, a low 10% chance of 5 years survival. Furthermore, according to the Société canadienne du cancer, in 2017, 8,700 lung cancers were diagnosed in Quebec, and 6,700 deaths occurred, attributable to the disease.

Lung cancer: more devastating in women than in men

Dr. Nicole Ezer, respirologist and director of the MUHC lung cancer screening program, encourages women who have been smoking for several years to register for the program: "Women who smoke or have smoked in the past will benefit even more from screening than men, according to studies. In Quebec, more women will die from lung cancer than from breast cancer. There is a lot of fatalism associated with lung cancer, patients are afraid to consult. I hope this campaign will encourage smokers and ex-smokers to take charge of their health and participate in screening."

The specialist, who has played a leading role in lung cancer screening for many years, also advocates a non-judgmental approach to those who are addicted to nicotine: "Even though 80% of lung cancer cases are related to smoking, I don't think it's appropriate to make smokers feel guilty, because it's first and foremost a societal problem. If cigarettes are available everywhere, over the counter, we cannot blame people for buying them. We have a responsibility to take care of these patients and find solutions that are going to have a positive impact for them. "

The fact that patients continue to smoke is not a reason not to be admitted to the program, but all health care professionals advocate for smoking cessation as the primary weapon against lung cancer. Support is available for patients who wish to take steps to quit smoking through the Quitnow line.

Who can participate?

To be eligible for the screening project, two important criteria must be met: you must be between the ages of 55 and 74 and have smoked for at least 20 years, consecutively or not, 20 cigarettes per day. The program is open to smokers or ex-smokers.

The provincial navigation center is responsible for ensuring patients are referred to the screening center closest to their home. For patients living in the west part of Montreal, for example, will be screened at the MUHC. A page on the MUHC website is dedicated to those who live in the area and are interested in enrolling in the screening program.

The outcomes of the 2 year screening program will support the decision to continue the project and expand it into a provincial program at further institutions across the province of Quebec.