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The Unmet Needs of Veterans and Lung Cancer

Lung cancer is a stealth disease that usually takes decades to develop and fails to show obvious symptoms, such as bloody sputum, until it has already spread beyond the original site.  In the general population only 16% of lung cancers are being diagnosed at an early localized stage when it can be treated and cured. Cancers with widely used screening methods (such as mammograms for breast cancer, PSA testing for prostate cancer and colonoscopies for colon cancer) have high survival rates. Currently the 5-year survival rate for breast cancer is 89%; for prostate cancer 99% and colon cancer 66%.

Survival Rates:

The 5-year survival rate for lung cancer is still only 15%, reflective of the persistent lack of adequate research funding and the pervasive blame associated with the disease. Neither is appropriate in addressing the unmet needs of veterans who by virtue of their service are at higher risk.

Imaging:

Rapid advances in imaging technology have now given those at high risk for lung cancer an option for detection at its earliest, most treatable and curable stage.  Fifteen years of observational studies in the United States and abroad have demonstrated that cancers detected by CT screening are highly likely to be cured.

Clinical Trials:

Randomized controlled trials to assess the impact on mortality are also underway in the United States and abroad, but none of these trials are focused on the military or veterans. It is urgent that the unique impact of lung cancer on veterans be researched.

Cost of Late Stage Lung Cancer:

Late stage lung cancer is twice as costly to treat as early stage cancer. Even conservative estimates place the cost of lung cancer to the VA at $1 billion a year. A study published in the April 29, 2009 Journal of Clinical Oncology predicts that the incidence of cancer overall will increase by 45% over the next 20 years, while the incidence of lung cancer specifically will increase by 52%. It is imperative that the VA initiate a pilot early detection research program targeting high risk veterans.

Screening:

Lung Cancer Alliance has consistently stated that those at high risk for lung cancer should speak with their doctors abut the risk and benefits of a CT scan, and to only have it done at centers experienced in lung cancer diagnosis.

The final word should go to Admiral Coady who in his annual message to veterans on behalf of LCA in 2007 said: 

When I was planning air defenses, I always used this simple fire doctrine: Shoot the wolf nearest the sled first. As a veteran, lung cancer may be the wolf that is closest to your sled.  It is clearly the number one cause of cancer deaths among veterans.  It is the Big Wolf and we are late in taking our shot at it. Take action to get this recognized by your Veterans Group so they can guide the VA and DoD to fund lung cancer screening efforts with this newly proven technology.

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