Italy joins China's battle against lung cancer

China will embrace Italy as its new partner in the uphill battle against lung cancer, with a focus on detecting the disease.

"This time our efforts will rest on capacity building work for lung and gynecological cancers prevention in less developed west China," said Qiao Youlin, a cancer epidemiologist with the Chinese Academy of Medical Sciences, adding that in the past "we've been focusing on clinic work when it comes to cooperation."

The government health departments and companies of two countries will cooperate on screening, detection and treatment as well as home care or palliative care of lung and gynecological cancers.

As part of this program, county-level medical workers in Chongqing will be given training on screening for breast, cervical and ovarian cancers. Zhou Qi, ex-director of Chongqing Cancer Center, noted that the lack of quality early screening has meant that some patients have missed an opportunity to get cancer treatment early.

These patients usually had short post-treatment survival periods and left a heavy financial burden to their families.

Lung cancer is by far the leading cause of cancer-related death among men and women in China, partially due to the poor survival rate. The five year survival rate of cancer in China is 30.9 percent for both male and female. According to Qiao, lower than half of that of America. The situation is even worse in rural China, where the survival rate is 21.8 percent, compared to 39.5 percent in urban areas.

Figures newly released by the National Cancer Center showed that there are approximately 650,000 new cases of lung cancer in China and that cancer claims 530,000 lives a year.

Globally, it estimates that there are 1.82 million new cases per year, and 1.59 million people will lose their lives to the disease.

The inability to provide quality early screening for cancer is the major factor behind the poor survival rate. This is particularly true in the economically disadvantaged western regions of China, Qiao said.

Lou Xiqiu, a peasant in Wenjiang county on the skirts of Chengdu, the capital of the Sichuan Province, is a heavy smoker, smoking pipe tobacco and cigarettes for about 40 years.

He is 65 years old and was diagnosed with lung cancer this year. He has had a couple of CT scans in the past, but these tests missed pre-cancerous changes in his lungs. Now the cancer is at an advanced stage. Zhou Qinghua, an internationally acclaimed thoracic surgery at the Lung Cancer Center of West China Medical University, performed surgery on Lou. He survived. But, Zhou said his post-treatment times may not be as long as the patients whose cancers were detected at an early stage.

"The CT scan requires experienced radiologists, equipment as well as lots of fund to support nationwide lung cancer screening," said Zhou, adding result from randomized controlled demonstrated a 20 percent reduction of lung cancer mortality with annual low-dose computed tomography (LDCT) scan in specific high-risk groups.

Due to the lack of quality screening, most lung cancers are already at an advanced stage when they are detected. LDCT scan can help find some of these cancers early, which lowers the risk of dying from the disease.

In 2009, China launched a LDCT screening program for lung cancer in people with high risk of the disease aged 50-74, who have a 20 pack-year smoking history, or had quit within the past 5 years. Zhou is leading the program carried out in six high-incidence provinces and cities, including southwestern Sichuan and Yunnan provinces, as well as Beijing and Tianjin municipalities. Using LDCT scan, 60 percent of 20,000 screened over the past three years were found to have cancer at an early stage, said Zhou.

Lung cancer is particularly a life-threatening disease as it tends to spread before it can be detected using simple imaging tests such as a chest x-rays. Zhou says, "The number of lives that surgery alone can save is limited, no matter how good you are as a thoracic surgeon. Therefore, LDCT as primary detection method is crucial. Surgery or chemotherapy, or radiotherapy is the last option."

The population is aging in China and the incidence rate of cancer increases as a consequence. Dr. Ranieri Guerra, director general for Preventive Health with Italian Ministry of Health, warned that if "we don't invest in early detection efforts now, the health system worldwide will go bankrupt if it tries to keep pace."

New immune oncological therapies and medicines are coming in the future but they will be very expensive, said Guerra. "In other words, the health system will not be able to sustain the financially related costs for all patients. Only those who are rich will survive."

The health ministers of China and Italy are expected to sign a memorandum on Sino-Italian health cooperation late this year, said Qiao. Endi