Starting in June, a pilot plan will launch a screening program in 38 hospitals, nine of them in Catalonia, in search of cases of lung cancer among the Spanish population between 50 and 75 years of age who smoke or are ex-smokers. The initiative promoted by the Spanish Society of Pneumology and Thoracic Surgery (Separ) promotes the performance of a CT scan to detect early lung lesions that may turn out to be cancerous before symptoms appear of the illness. This new advance in the field of preventive medicine will serve to assess whether this screening is definitively linked to the three programs already widely implemented in Spain and included in the portfolio of common services of the National Health System to detect early cases of breast cancer, colorectal cancer, or cervical cancer.
There are epidemiologists who question, despite the consensus reached by nine Spanish medical societies, the advisability of generalizing a expensive radiological test not only in cases where there are suspicious symptoms but also in the entire tobacco consuming or ex-consuming population, given the need for strengthen campaigns against smoking and facilitate access to the cessation programs of this dependency. There must not be, however, no contradiction between one thing and another, in the same way that the promotion of healthy lifestyle habits that can reduce the incidence of other types of tumors goes hand in hand with measures to detect their development early and consequently reduce mortality.
Although this lung cancer detection campaign requires diagnostic instruments that are more sophisticated, more expensive, and involve a higher dose of radiation than the detection of colon cancer through traces of blood in the stool, cytologies to prevent cervical cancer or radiological examinations to detect mammary tumors, the incidence of this pathology explains why the implementation of this campaign is considered. Lung cancer is the one that causes the most deaths in the world, and also in Spainjust above those of the colon, pancreas, breast and prostate.
The results of the most consolidated screening campaigns are clear. For example, between 2002 and 2020, while the incidence of breast cancer in Spain increased from 106 to 126 cases per 100,000 women per year, mortality decreased in the same period from 29 to 22.8 per 100,000 women. In the case of colon cancer, screening manages to reduce mortality by between 30% and 35% in the short term: if resistance to undergoing the test subsides, up to 3,500 lives a year would be saved.
For the moment, the chest CT examination of the smoking population, in a test population of 50,000 people, is a step prior to its possible widespread implementation in the year 2028. If the results of other countries can be replicated, in which this type of screening has reduced mortality by 24% due to lung cancer, its generalization in the offer of Spanish public health services will be fully justified.