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Lung cancer: let’s try for prevention and cure

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Emphasising prevention and ensuring best practice through access to continually updated treatment guidelines are needed to improve outcomes

In this issue of the Journal, Mitchell and colleagues report a follow-up survey from Victoria on the management of lung cancer, 10 years after an initial survey in 1993.1 The issues of therapeutic nihilism,2 variation in management and poor survival remain, but it is encouraging that there are improvements. Moreover, the follow-up was until 2003 so that 5-year results after that time could be reported, and further advances have undoubtedly occurred in the subsequent decade.

In the Mitchell et al study, the crude 5-year survival rate for patients with non-small cell lung cancer (NSCLC) was 10.8%, but the important finding was that for those with NSCLC treated surgically with curative intent, it was 43.2%. Even those with locally advanced disease treated with radiotherapy or chemoradiotherapy had a 5-year survival rate of 19%. This emphasises the importance of offering treatment to patients with early-stage disease and, in this study, many patients’ lung cancers were detected as an incidental finding during thoracic imaging for other reasons. It is problematic…