CT scan of 72-year-old woman shows dominant pulmonary nodule (arrow) in right lower lobe that proved at pathology to be adenocarcinoma. Source: American Journal of Roentgenology, Ginsberg et al, 2004.

Senator Dianne Feinstein (D-Calif.), and co-sponsors Senator John Isakson (R-Ga.) and Senator John Kerry (D-Mass.), have introduced the Lung Cancer Mortality Reduction Act of 2011 (S. 752).

The bill aims to establish a comprehensive interagency response to achieve a 50 percent reduction in lung cancer mortality by 2020.

It calls for a five-year screening demonstration program to begin the process of translating initial results of the National Lung Screening Trial (NLST) into public health benefit. The NLST indicated that low-dose CT screening of an at-risk population can significantly reduce lung cancer mortality.

The demonstration project is designed to achieve four objectives. These are:

• To identify the optimal risk populations that would benefit from screening;
• To develop the most effective, safe, equitable and cost-efficient process for screening and early disease management;
• To allow for continuous improvements in quality controls for the process; and
• To serve as a model for the integration of health IT and the concept of rapid learning into the healthcare system.

The legislation also recommends allocating funds to the FDA Center for Devices and Radiologic Health to establish quality standards for providers of CT-based lung cancer screening and “provide for expedited revision of standards and guidelines, as required to accommodate technological advances in imaging.”

The bill would authorize and fund a Lung Cancer Detection Program, designed to provide low-income, uninsured and underserved populations that are at high risk for lung cancer access to early detection services.

The National Cancer Institute estimates that in 2010, there were 222,520 new diagnoses of lung cancer and 157,300 deaths attributed to the disease. Furthermore, according to projections published in the Journal of Clinical Oncology in 2009, between 2010 and 2030, the incidence of lung cancer will increase by 46 percent for women and 58 percent for men. The increase in incidence among minorities will range from 74 percent to 191 percent. Meanwhile, the five-year lung cancer survival rate stands at 15 percent.