Nova Scotia launches screening program for lung cancer

Nova Scotia has launched a screening program for people at very high risk of developing lung cancer.

For Dr. Daria Manos, it was an announcement years in the making.

"What a momentous day," she said during a news conference in Halifax on Friday. "We need this program. Lung cancer kills more Nova Scotians than colon, prostate and breast cancers combined."

Manos, a radiologist and medical director of the lung screening program, said the news follows years of research, consultation, planning and advocacy.

The program includes clinical assessments and CT scans.

Nova Scotians aged 50 to 74 who have smoked daily for 20 years or more at any point in their lives can contact the program and have a nurse assess their personal risk of lung cancer to determine if they would benefit from screening with a chest CT scan.

People will be able to refer themselves to the program and do not need a family doctor.

Dr. Madelaine Plourde, Nova Scotia Health's chief of thoracic surgery, said early detection of lung cancer is vital to a positive outcome.  Three-year survival rates can be greater than 80 per for people diagnosed at Stage 1; the number plummets to just eight per cent when someone reaches Stage 4.

"Unfortunately, about 70 per cent of the patients we see will be found to have advanced-stage lung cancer at the time of their diagnosis. This means that they will not be offered the chance for curative treatment," she said.

"The truth is, if you are presenting with symptoms of lung cancer, it's already too late."

Along with screening, the program is also focused on confronting the shame that can be associated with people who smoke and get lung cancer. There will be education about lung health and support and resources to help people quit smoking. Free nicotine replacement therapy will be provided.

"Smoking is an addiction," said Manos. "We are here to help. It is never too late to benefit from quitting smoking."

Education is something Kendra Slawter is pleased to see included in Friday's announcement. The patient advocate lost four members of her family in the last decade to cancer.

Slawter said she's hoping the new program can help spare others the pain her family has experienced. It's important to acknowledge that people don't always have the ability to make lifestyle changes on their own, she said.

Making these tools available, and putting a particular emphasis on marginalized communities that have experienced systemic barriers to accessing care, is an important step, said Slawter.

"My hope for the program going forward is for people to see the benefit in quitting and understand that it's not too late and that there's supports there to help you."

Variety of factors drive high cancer rates

Health Minister Michelle Thompson said the time was right to launch the screening program because of the advocacy work and professional expertise that's pushed for it for years.

"Fixing health care means we have to improve cancer screening and the care," she said.

"Simply put, this program will help prevent and detect lung cancer earlier. It will help save lives."

Friday's announcement follows others in recent months aimed at improving cancer care.

The government has announced funding for new forms of therapy and treatments and a major push to expand the use of technology for more individualized treatment options that in many cases mean less invasive procedures for shorter periods of time.

It also comes at a time when updated statistics show Nova Scotia has the highest incidence rate for cancer in the country.

Eastern provinces historically have had higher rates of cancer due to factors such as aging demographics, environmental considerations and lifestyle factors such as higher rates of smoking, drinking, obesity and chronic disease than the rest of the country.

Putting an increased focus on prevention

Dr. Helmut Hollenhorst, the senior medical director of the province's cancer care program, told CBC News in a recent interview that about 45,000 Nova Scotians today live with cancer. That number is expected to grow to 200,000 by the end of the decade as the population ages, he said.

While that can sound startling, Hollenhorst said there can be a good quality of life beyond a diagnosis with early and timely access to the right treatments and therapies. It's also why there needs to be more focus on prevention, he said.

Hollenhorst estimates that between 30 and 50 per cent of cancers can be prevented if people avoid smoking and drinking, maintain an active lifestyle and make fruits and vegetables a regular part of their diet. People should also be mindful of environmental factors such as arsenic in water and radon gas in their home, he said.

Enhanced prevention efforts will require help from a variety of partners across the health-care system and government more broadly, said Hollenhorst. The benefit of positive health and lifestyle choices will not only reduce the risk of cancer, but also the risk of other chronic diseases, he said.

"This is something where we don't see impact quickly. We are in for the long haul and we need to change the trajectory of health in general and primary prevention is key and it needs to be addressed to make a difference in the long term."

Lung screening program starts in central zone

The new lung screening program is available in the province's central health zone by calling 1-833-505-5864.

It will be rolled out across the province over the next two years. The provincial government will spend $3 million a year on the program when it is fully implemented across Nova Scotia.

The Canadian Partnership Against Cancer has contributed $350,000 to the program and is also committing nearly $1 million over the next three years to develop strategies to reach diverse and vulnerable populations.