Medical experts push for early lung cancer screening among Filipinos

Higher mortality rates due to lung cancer may be avoided if there is increased early detection of the disease, medical experts said on Thursday, as they pushed for the use of artificial intelligence (AI) in lung cancer screening tests.

At a media roundtable discussion in Makati City, lung cancer specialist and thoracic oncology expert Dr. Tony Ramos noted that in the Philippines, only 7% to 8% of patients were diagnosed with lung cancer early enough for them to receive surgical treatment.

This was because most patients only had themselves checked by a doctor when their symptoms got worse.

“Pupunta sa’yo may tubig na ‘yung baga, malaki na bukol… If we can bring down the staging and diagnosis by doing early lung cancer detection, malaking bagay ‘yun sa pamilya, sa gobyerno, sa pasyente rin,” he said.

(They would go to you with water already in their lungs or a large lump… If we can bring down the staging and diagnosis by doing early lung cancer detection, that’s already a big improvement for the family, for the government, and the patient.)

Ramos stressed that higher early detection rates eventually led to lower mortality rates. He cited Taiwan, where around 90% of lung cancer patients received treatment at stage 1 due to early screening of the disease.

He added that the use of AI technology in low-dose CT scans and chest X-rays would immensely help in diagnosing and treating lung cancer in its early stages.

Dr. Cyril Torosa, AstraZeneca Philippines medical affairs director, similarly observed that there is low health-seeking behavior in the Philippines due to several factors, including financial costs.

For example, the cost of getting a PET CT scan in a private hospital in Makati City would range from P75,000 to P163,000. At the Philippine General Hospital (PGH), the diagnostic exam would cost around P3,000 to P19,000.

As an alternative, Torosa said they are pushing for AI integration in standard chest X-rays to flag lung nodules that often indicate the risk of lung cancer.

“Especially [for the] working class, you [would] come in for an annual physical examination since that’s the standard. That’s where we can actually start. That’s where we try to partner with these institutions and by establishing AI with these participating institutions, hopefully we’d be able to screen who among these patients might actually have the lung nodule,” he said.

Torosa said their current AI models flagged around 4% of their scans for potential high risk for nodules.

By tapping AI to flag high-risk patients, radiologists would be able to make better diagnosis and assessments for referral.

“The lung nodule, especially at the early stage, we cannot see it. The capability of the radiologist [to see it] probably would be one centimeter or higher, but the smaller ones is very difficult. That’s where the AI comes in,” Torosa said.

AstaZeneca is currently using its AI-assisted X-ray technology at an institute in Cavite. It has run at least 9,000 x-rays with AI integration.

To ease financial burdens, AstraZeneca and Ramos also called on the Philippine Health Insurance Corporation (Philhealth) to increase its coverage for CT scans by including low-dose CT scans even without a cancer diagnosis.

Lung cancer remains one of the deadliest and most prevalent cancers in the country.

In 2022, the Philippines had 23,728 new cases of lung cancer, accounting for 12.6% of cases around the world for that year.

Lung cancer also caused 20,953 deaths in 2022, accounting for 18.5% of cancer-related deaths in the country.

Lung cancer often develops in high-risk individuals such as smokers, people with genetic history of lung cancer, and people exposed to second-hand smoke, radon, or asbestos. — JMA, GMA Integrated News