Norway considers lung cancer screening: Researchers discovered the silent killer in Arne Larsen's lungs
Lung cancer is often called the ‘silent killer' because many people don’t realise they’re ill until it’s too late. Arne Larsen was fortunate that his cancer was detected before it became life-threatening. Researchers hope that many more lives can now be saved.
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The Norwegian Directorate of Health is currently evaluating whether it would be wise to implement lung cancer screening in Norway.
Studies from other countries have shown very positive outcomes from screening programmes. Soon, we will have Norwegian data on this as well.
In a new study conducted by Oslo University Hospital (OUS), researchers have already screened 1,500 people for lung cancer and plan to screen another 1,000 participants this autumn.
Trond-Eirik Strand, a professor of public health at OUS, is the deputy leader of this ongoing study. During a recent event at Arendalsuka, an annual political event in Norway, he shared that they have already seen promising results, although these have not yet been published.
Selected twice
Arne Larsen is one of the participants in the study.
He was first selected for a colorectal cancer screening study in 2015, where he was asked about his smoking habits. He honestly admitted to having used a lot of tobacco in his life.
He then received an invitation to participate in a lung cancer screening study.
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The screening revealed a small tumour, which was then surgically removed.
“I was discharged shortly after the operation and felt pretty good. I’ve felt good ever since. Now I’m followed up twice a year,” he says.
No symptoms
Larsen experienced no pain or other symptoms indicating that he had lung cancer.
“The doctors told me that we don't have pain nerves in the lungs. This means you don’t realise you have cancer until the tumours start affecting other organs and causing problems. I find that interesting because if it’s caught early, you don't have to die in agony,” he says.
Lung damage occurs slowly, which is why many people diagnosed with lung cancer quit smoking years before.
This was the case for Arne Larsen when his tumour was discovered.
In the study, all participants who still smoke are offered a smoking cessation programme. The researchers do not yet know how many of these have stopped smoking.
“But most have accepted the offer to join the smoking cessation programme,” says Strand.
Claims the most lives
Lung cancer is the leading cause of cancer-related deaths in Norway. Last year, just over 3,300 people were diagnosed with lung cancer, and more than 2,200 lost their lives to the disease.
But it doesn't have to be this way. Lung cancer is treatable, according to cancer specialist Åslaug Helland at OUS.
“When I first started treating cancer patients, it was almost better to detect lung cancer as late as possible because patients would die regardless. But today, that’s no longer the case. We’ve made significant strides in surgery, radiation therapy, and the medications available for these patients,” she says.
Helland believes that if lung cancer screening is implemented, it could lead to much earlier detection, allowing for treatments that aim to completely cure the disease.
Primarily caused by smoking
The rise in lung cancer cases began after World War I.
“The tobacco industry likely played a role, as more people started smoking during that time. It’s only now, long after we started encouraging people to quit smoking, that we’re seeing a decline in the number of lung cancer cases,” says Helland.
Despite this, she believes that lung cancer will continue to claim many lives in the coming years because the disease develops very slowly.
Lung cancer is closely linked to smoking, but smoking is not the only risk factor, Helland points out.
“Cigarette smoking accounts for about 80-90 per cent of the risk, but air pollution, radon, and asbestos are also risk factors. Some individuals are more genetically predisposed to lung cancer, and unfortunately, some just have bad luck,” she says.
More occasional smokers
The number of daily smokers has decreased significantly in Norway. However, Andreas Høiaas, a senior adviser at the Norwegian Cancer Society, sees some concerning trends on the horizon.
Occasional smoking has become more common. In fact, one in five young people aged 16 to 24 now smokes occasionally, and three per cent of this age group smoke daily.
E-cigarette use is also common among young people.
“If these trends continue, about 400 of those born in 2010 will die from lung cancer,” says Høiaas.
Ban on tobacco sales?
The Norwegian Cancer Society is pushing for a tobacco-free generation. They have proposed a ban on the sale of tobacco for smoking to those born after 2002.
They are also advocating for stricter regulation of social media content.
“There’s an alarming amount of tobacco exposure aimed at children and adolescents on these platforms,” says Høiaas.
Careful deliberation
The Directorate of Health is currently making thorough evaluations as it considers the implementation of lung cancer screening in Norway. This process is being carried out in close collaboration with medical experts.
The working group at the directorate is now deeply involved in this effort, and by the end of 2025, they are expected to provide their recommendation to the health authorities.
The EU has recently advised its member states to consider implementing lung cancer screening programmes.
Risk of overdiagnosis
Norway already has three established screening programmes for breast cancer, cervical cancer, and colorectal cancer.
However, there is a risk of overdiagnosis with screening, warns Trond-Eirik Strand.
“We don't know if the tumour removed from Arne’s lungs would have become dangerous. But there was a significant risk that it could have. He might be one of the few who are overdiagnosed. This is one of the downsides of screening,” says Strand.
Arne Larsen, however, is glad that the tumour was removed from his lungs.
“I’m more than willing to take that risk,” he says.
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Translated by Alette Bjordal Gjellesvik
Read the Norwegian version of this article on forskning.no
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