What is the future of lung cancer management in Saudi Arabia?

From the Guidelines

The future of lung cancer management in Saudi Arabia will likely prioritize tobacco control, early detection through low-dose CT screening, and the adoption of targeted therapies and immunotherapies. According to the study published in the Journal of the National Comprehensive Cancer Network 1, lung cancer is a significant health concern in Saudi Arabia, with an age-standardized rate of 6.1 per 100,000 in men and 1.9 per 100,000 in women. The incidence of lung cancer in Saudi Arabia increased by 57% between 2001 and 2005, highlighting the need for effective prevention and management strategies.

Some key strategies for improving lung cancer management in Saudi Arabia include:

• Implementing nationwide low-dose CT screening programs targeting high-risk populations, particularly smokers aged 50-80 with significant pack-year histories
• Adopting targeted therapies like osimertinib for EGFR mutations, alectinib for ALK-positive cases, and immunotherapies such as pembrolizumab and nivolumab
• Making molecular testing a standard practice, with comprehensive panels detecting actionable mutations in EGFR, ALK, ROS1, BRAF, and NTRK genes
• Developing more specialized thoracic oncology centers with multidisciplinary teams, particularly in underserved regions
• Investing in local clinical trials and research initiatives to address lung cancer patterns specific to the region

The study 1 also emphasizes the importance of addressing tobacco use, the main risk factor for lung cancer, through control measures and public awareness campaigns. By prioritizing these strategies, Saudi Arabia can reduce the burden of lung cancer and improve outcomes for patients. Telemedicine and AI-assisted diagnostic tools can also help overcome geographical barriers to care, ensuring more equitable access to specialized treatment throughout the kingdom.

From the Research

Overview of Lung Cancer in Saudi Arabia

• Lung cancer is a major health problem in Saudi Arabia, with a high incidence and mortality rate 2.
• The disease is often diagnosed at an advanced stage, with only 14% of cases diagnosed at an early stage 2.
• The stage of the tumor is the strongest predictor of mortality for both small-cell and non-small cell lung cancers 2.

Lung Cancer Prevention and Screening Guidelines

• Guidelines for lung cancer prevention and early detection have been developed in Saudi Arabia, emphasizing primary and secondary prevention approaches, including tobacco control and lung cancer screening 3.
• However, the guidelines do not recommend a national screening program for lung cancer at this stage, citing the need for more data and studies to justify its adoption 3.
• Physicians play a crucial role in preventing lung cancer through tobacco control and early detection 3.

Public Knowledge and Attitudes towards Lung Cancer Screening

• A cross-sectional study found that the Saudi public has a positive inclination towards lung cancer screening, but there are significant knowledge gaps, particularly regarding non-smoking related risk factors and misconceptions 4.
• Younger participants and those with higher education demonstrated better knowledge scores, with significant differences based on age and education level 4.
• There is a need for enhanced public education and screening programs to address these knowledge gaps 4.

Physician Knowledge and Attitudes towards Lung Cancer Screening

• A study found that physicians in Saudi Arabia have a significant degree of understanding regarding lung cancer screening, but there are barriers to discussing screening results with patients, including patient scheduling and refusal 5.
• Physicians in private hospitals demonstrated a higher level of knowledge of lung cancer screening compared to others, while those with 11-15 years of experience had a lower likelihood of being educated about lung cancer screening 5.
• There is a need for specialized educational initiatives and continuing medical education programs to address these knowledge gaps and facilitate communication between physicians and patients 5.

Epidemiological Analysis of Lung Cancer in Saudi Arabia

• A retrospective cohort study found that the incidence of lung cancer has increased significantly among the Saudi population, with a rise in crude incidence rates and age-standardized incidence rates 6.
• The incidence of lung cancer increased with age, with 23% of cases reported in the age group of more than 75 years 6.
• The Eastern region had the highest overall age-standardized incidence rate among males, while the highest overall age-standardized incidence rate among females was reported in the Eastern region followed by Riyadh and the Northern region 6.