Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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EDITORIAL
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 197
Saudi lung cancer prevention and screening guidelines


Thoracic Surgery, Saint Thomas Health, TN, USA

Date of Submission10-Sep-2018
Date of Acceptance18-Sep-2018
Date of Web Publication10-Oct-2018

Correspondence Address:
Dr. John Howington
Chairman of Thoracic Surgery, Saint Thomas Health, 4230 Harding Pike Suite 530, Nashville, TN, 37205
USA
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DOI: 10.4103/atm.ATM_259_18

PMID: 30416589

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How to cite this article:
Howington J. Saudi lung cancer prevention and screening guidelines. Ann Thorac Med 2018;13:197

How to cite this URL:
Howington J. Saudi lung cancer prevention and screening guidelines. Ann Thorac Med [serial online] 2018 [cited 2018 Dec 13];13:197. Available from: http://www.thoracicmedicine.org/text.asp?2018/13/4/197/243051


Lung cancer is the number one cancer killer worldwide. Unlike other major cancers, lung cancer has a unique feature which is a known risk factor for majority of the cases. In the United States, cigarette smoking is linked to about 80%–90% of all lung cancers. This knowledge represents a great opportunity to prevent the majority of lung cancers by tobacco control. On the other hand, knowing the majority cause enables us to identify patients at risk to implement early detection and screening interventions. These facts were translated into clear standard of care and practice guidelines in developing countries. In the United States, lung cancer screening guidelines are now evidence based and becoming the standard of care for high-risk population based on the National Lung Screening Trial and other studies. However, it is critical to have these guidelines be adapted to the particular setting.

The approach followed by Jazieh et al. in proposing the Saudi Lung Cancer Prevention and Screening Guidelines is a sound approach to address this challenge. The individual practitioner should identify smokers and offer them counseling and assistance to stop this deadly habit. This is a low-cost intervention with a high impact on improved overall health and reduced cancer risk.

Physicians should be fully aware of the screening guidelines and apply them to individual patients after proper assessment and counseling. However, implementing lung cancer mass screening as a national project should be done at later stage as the authors have suggested. In 2014, lung cancer represented fewer than 5% of all cancer cases among the Saudis. Lung cancer was the fifth most common cancer in Saudi males (6.6%) and remains quite uncommon in Saudi females (<2%). As the prevalence of lung cancer in the Kingdom of Saudi Arabia (KSA) is much lower than the western countries, the presence of other chest diseases is not fully known, and therefore, the cost-effectiveness of mass screening should be assessed specifically to the population within the KSA.

These guidelines provide a practical framework for the healthcare professionals in Saudi Arabia to follow to detect early-stage lung cancer which is correlated with better patient outcomes. Most importantly, if followed, effective tobacco control should help prevent the occurrence of lung cancer in the first place, in addition to avoiding all the emotional, physical, and financial burden of overall lung disease.

Feasibility studies should be performed to accurately identify the current prevalence of lung cancer and other pulmonary diseases in the KSA. The procedures performed to diagnose cancer should be assessed for the negative and positive predictive values of the tests within the Saudi Health System. After such feasibility studies, decision to implement a national program for early detection of lung cancer can be considered.

Meanwhile, all healthcare professionals should step up their efforts in preventing the occurrence of cancer by eliminating the main culprit, tobacco use.






 

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