The Challenges and Opportunities in Lung Cancer Screening in Pakistan: Bridging the Gap in Early Detection and Care

Abstract

Lung cancer remains one of the leading causes of cancer-related mortality globally, with its burden rising in low- and middle-income countries like Pakistan. Despite being among the five most common cancers in the country, accurate data on lung cancer incidence are limited due to underreporting and inadequate cancer registries. Smoking, air pollution, and biomass fuel use are key risk factors contributing to its prevalence. Early detection through low-dose computed tomography (LDCT) screening has been shown to reduce lung cancer mortality significantly, as evidenced by international studies like the NELSON trial.

However, Pakistan faces significant barriers to implementing such screening programs, including insufficient CT scanner availability, a shortage of trained healthcare personnel, and logistical challenges. Furthermore, the high prevalence of lung infections, particularly tuberculosis, increases the likelihood of false positives during screenings, adding complexity to diagnostic efforts.

Integrating smoking cessation counseling into screening programs and cost-effective diagnostic techniques like CT-guided biopsies could enhance the overall impact of lung cancer screening. Additionally, advancements in artificial intelligence offer opportunities to alleviate the workload of radiologists, although these technologies require further development for reliable automated evaluations.

While infrastructural and resource limitations hinder immediate implementation, addressing these gaps could make lung cancer screening a vital tool in combating the disease's growing burden in Pakistan.