In a debate at the Special Commission on Combating Cancer this Tuesday (25), the National Cancer Institute (Inca) and the Alliance against Lung Cancer, formed by six medical societies, disagreed regarding the emphasis on screening among strategies to combat cancer.

Currently, lung cancer is the third most prevalent among men and the fourth among women. There are around 32 thousand new cases per year in Brazil and 1.7 million worldwide. Around 90% of cases are associated with smoking and symptoms begin to appear at an advanced stage of the disease, generally over 50 years of age.

For these reasons, the general director of Inca, Roberto de Almeida Gil, emphatically defended tobacco control and early diagnosis campaigns as “the only way to deal with the increase in cases due to the aging of the population”. He highlighted that public prevention policies have reduced the incidence of the disease from 35% to 12%, accompanied by a drop in mortality, especially among men, since 2005.

According to Gil, screening has potential benefits and risks for the patient. There is also concern about the rate of false-positive results in patients with tuberculosis and other diseases. “We have to be very careful, because our care network today is not yet prepared to deal with advanced disease. We have many bottlenecks. That a tracking program doesn’t come to strangle an entire system that is already very stressed today.”

The honorary president of the Brazilian Society of Clinical Oncology (SBOC), Carlos Gil Ferreira, admitted the relevance of awareness campaigns, but said that screening strategies are a “window of opportunity to combat the disease”.

Tomography
The scientific director of the Brazilian Society of Thoracic Surgery (SBCT), Daniel Bonomi, recalled that the old practices of x-rays and sputum examination were replaced by low-dose computed tomography (CBCT), with positive results for diagnosis and treatment.

“The technological world has advanced too much, with investment and low-dose tomography. The pandemic showed that we have enough CT scans. Just change the dosage. It’s simple. And screening is the beginning of an improvement in respiratory medicine.”

Representatives of the Brazilian Society of Pulmonology and Phthisiology (SBPT) and the Brazilian College of Radiology and Diagnostic Imaging (CBR) cited scientific evidence that screening “anticipates diagnosis and reduces mortality”.

The Brazilian Societies of Pathology (SBP) and Radiotherapy (SBRT) are also part of the Alliance against Lung Cancer, with support from the Brazilian Medical Association (AMB).

Projects
Organizer of the debate, deputy Flávia Morais (PDT-GO) is already the author of Bill 2158/24, which restricts the sale of electronic cigarettes. She has just made Project Law 2550/24 official, with standards for tracking the disease.

“This project will establish guidelines for screening and early diagnosis of lung cancer. Today we already have laws that address this issue regarding other types of cancer, such as breast and prostate.”

During the hearing, doctors presented successful experiences of lung cancer screening in hospitals in São Paulo and Rio Grande do Sul, including with patients from the Unified Health System. On behalf of the National Council of State Health Secretaries (CONASS) , César Neves, from Paraná, defended prevention and also showed enthusiasm for screening strategies.

“We have to have primary care with a vigilant eye for symptoms that are often incipient and carry out prevention. And we have no doubt that early screening will change the natural history of patients and also alleviate the coffers of the weakened public system, which spends much more on advanced-stage treatments and palliative medicine.”

Neves also defended the regulation of the National Cancer Prevention and Control Policy ( Law 14,758/23 ), reinforcing the role of primary care.

Source: Agência Câmara de Notícias