“Lung cancer deaths could be reduced by up to 30%, while in 70% of cases the diagnosis would be made at an early and completely manageable stage, in which a radical cure could be achieved, if screening was applied to the high-risk population danger. And unfortunately, at the moment, over 60% of the people who come to us are already at an advanced stage of the disease.” The highlights belong to Secretary of the Thoracic Oncology Plenary at the European Pulmonology Society, Coordinator of the Lung Cancer Working Group of the EPE and combat pulmonologist of Sotiria, Georgia Hardavella.

Who are the candidates?

Ms. Hardavella, who is giving an interview to Fm Agency and Tania Madouvalou, on the occasion of her speech at the 4th annual conference of the non-profit organization FairLife LCC, explains that screening for lung cancer involves a low-dose chest CT scan that it is done every two years (unless there are specific conditions and it must be done every year). “Candidates who can be screened are people aged 50 to 80 who smoke or have smoked at least one pack a day or if they have stopped smoking with a corresponding smoking habit in the last 15 years. The part of screening also includes smoking cessation, for someone who is a current smoker, and this is the only way this intervention makes sense.”

At least 8 out of 10 lung cancer cases are due to smoking – What has been done so far in Greece

According to Ms. Hardavella, the Hellenic Pulmonology Society along with her Hellenic Radiological Society and with her Hellenic Society of Cardiothoracic and Vascular Surgeonscreated a group of 55 health professionals, who developed guidelines for lung cancer screening and defined the process, that is, how it will be done in our country’s health system. “Now we are in the phase where we also define the training framework, that is, how health professionals should be trained to implement this program, which we presented last year at an event of the Pulmonology Society. The program has been delivered by the EPE to the leadership of the Ministry of Health and specifically, to the acting Minister of Health Anastasia Kotanidou in June 2023, and then in December of the same year to Mrs. Agapidakis. Since then, the scientific community has been in a waiting phase and we are anxiously waiting to see how the State can utilize these tools, which we have produced after three and a half years of effort.” However, it is recalled that in a recent interview, the Deputy Minister of Health announced that a program for the early detection of lung cancer is expected to be implemented in 4 hospitals within 2025. To the question, out of ten cases of lung cancer, how many are due to smoking, Ms. Hardavella answers: “At least 8. And we have not calculated (and I say this with reservations about what the data will show in the future), even with exact percentages those who vaping or making electronic cigarettes, because we also have many alternative tobacco products in recent years).

In which countries is a screening program implemented – What are the difficulties?

What is being done in other countries and why until today there are difficulties in the implementation of such a program, is the next question posed to Ms. Hardavella. “In Europe, screening programs are implemented in three countries: Croatia, Czech Republic, Poland. In the UK on a fairly large level and quite organized and in the rest of Europe either small-scale pilot programs or studies are running. The US has a screening program, while Canada has a regional program.” But why are so few countries in Europe implementing such an important program? “Based on the literature and what we know, the big problem is firstly, that there are not many chest radiologists who need to be specialists to diagnose them, secondly, the staff should be increased because the working time of all the health professionals involved is also increasing in screening and thirdly, it is the issue of cost because it is a public health measure that must be implemented and every citizen has equal access, regardless of where they live. Insular Greece, as well as mountainous inaccessible areas, are issues that will arise in the future. For this and the data we will collect, when the screening is implemented, it will be valuable for the rest of the countries to see exactly what will happen in Greece”.

Screening in 3 public hospitals in Greece

Despite the fact that at the moment, many screening programs are running in our country, for the above reasons the early diagnosis of lung cancer, which is a cancer with high mortality, has not yet been included in a national program. However, according to Ms. Hardavella, sporadic efforts are being made in three public hospitals in Greece. “From the summer of 2022 we have started an effort in Sotiria and operate a Screening Clinic that is open to the public every Wednesday 11:00 – 13:00. Citizens can make an appointment via 1535 and the code of the practice is 09048. At this Practice, they are evaluated and if the conditions are met, they do the low-radiation x-ray at the hospital for free and they also have access to a smoking cessation service. Similar programs are implemented at the University Hospital of Larissa, but also at the “Papanikolau” of Thessaloniki. But, I stress, these efforts are not a national program.”