Simple Blood Test Predicts Lung Cancer Mortality Risk

Lung cancer accounts for approximately 25% of cancer-related deaths, with early detection significantly enhancing survival rates. However, most countries do not implement screening measures for lung cancer. Currently, lung cancer screening is advised only for adults identified as high-risk due to their high susceptibility. The U.S. Preventive Services Task Force (USPSTF) recommends such individuals undergo a yearly low-dose CT scan, proven to mitigate lung cancer mortality. Nevertheless, considering the difficulties associated with employing CT as the primary screening method for lung cancer and the fact that most diagnosed individuals do not meet current guidelines, there is an urgent need for an alternative strategy. Now, a curated blood test, when used alongside a predictive model, has shown potential in reducing lung cancer deaths by informing the need for CT screening.

Researchers at The University of Texas MD Anderson Cancer Center (Houston, TX, USA) have developed a blood test that, when paired with a personalized risk model, can predict an individual's risk of dying from lung cancer. When this blood-based four-protein panel (4MP) is combined with a lung cancer risk model (PLCOm2012), it is more effective at identifying those at high risk of dying from lung cancer as compared to the existing USPSTF criteria. These findings build upon earlier MD Anderson studies demonstrating that the combined test more accurately identifies who is likely to benefit from lung cancer screening than the USPSTF criteria. The 2021 USPSTF criteria apply to adults aged 50 to 80 with a minimum 20 pack-year smoking history, currently smoking or have quit within the previous 15 years.

In this study, the researchers analyzed pre-diagnostic blood samples from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The samples included 552 individuals later diagnosed with lung cancer and 2,193 individuals who were not. Of the 552 individuals diagnosed during the six-year study period, 70% (387) succumbed to lung cancer. The researchers used hazard ratios to evaluate the correlation between the risk scores produced by the combination model (4MP + PLCOm2012) and the incidence of lung cancer death. The combination model outperformed both the 2013 and 2021 USPSTF criteria in terms of sensitivity, specificity, and positive predictive value for predicting lung cancer-specific mortality among individuals who smoked at least 10 pack-years (PYs). While this blood test could be introduced as a lab-developed test in the near future, FDA approval would likely require evaluation through a prospective clinical trial.

“This simple blood test has the potential to save lives by determining the need for lung cancer screening on a personalized basis,” said co-corresponding author Samir Hanash, M.D., Ph.D., professor of Clinical Cancer Prevention.

“For individuals who currently are not eligible for lung cancer screening, a positive test may help to identify those possibly at risk for lung cancer death,” added co-corresponding author Edwin Ostrin, M.D., Ph.D., assistant professor of General Internal Medicine. “We envision this as a tool that could be deployed worldwide, as the future of early detection of this disease.”

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The University of Texas MD Anderson Cancer Center 

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