Exploring the Efficacy and Feasibility of using Biomarkers for Early Screening of Lung Cancer and their Potential Reverberation on Mortality Rate: A Review

Introduction Lung cancer patients often have a poor prognosis, due to various factors that play into the diagnosis, such as timeframe, early detection, and progression. The rate of patients with advanced-stage lung cancer is often high due to the inability to be diagnosed early. The lack of screening, therefore, increases the mortality rate of lung cancer. High mortality rate is also attributed to advanced lung cancer cases that are undiagnosed due to the lack of symptoms in patients early in disease acquisition. Methods This review explores lung cancer screening methods adopted around the world and those with the most promising standardizations. Criteria used to filter articles included lung cancer methods using biomarkers, research conducted in the United States within the past 10 years, screening methods observed in a clinical setting, and patients with primary lung cancer. Some practices that can be utilized to improve screening for lung cancer may involve using genetic markers to identify patients possessing genetic makeup associated with lung cancer. Results Our study included 32 articles in our review calculating the sensitivity and specificity for a variety of potential biomarkers including: 1) Volatile organic compounds has a specificity of 80% and sensitivity of 80% 2) Circulating tumor DNA has a sensitivity of 80% and specificity of 96% 3) miRNA molecules (miR-146-5p, miR-324-5p, miR-223-3p, and miR-223-5p) displayed sensitivities of 93%, 94%, 96%, and 95% respectively, with specificities of 33%, 23%, 27%, and 26% respectively 4) methylation beads specific genomic sequences (SOX17, TAC1, HOXA7, CDO1, HOXA9, and ZFP42) with sensitivities of 84%, 86%, 63%, 78%, 93%, and 87% respectively when found in sputum and 73%, 76%, 34%, 65%, 86%, and 84% respectively when found in serum. Specificities were calculated at 88%, 75%, 92%, 67%, 8%, and 63% respectively when found in sputum, and 84%, 78%, 92%, 74%, 46%, and 54% respectively in serum 5) Ga-Alfatide II scans were found to have a sensitivity of 86% and a specificity of 85% 6) Combined score had a sensitivity of 78% and specificity of 50% 7) WT-IDH had a sensitivity of 63% and specificity of 93%. Discussion In such a high-risk patient population, cautious preventative measures can be used such as lifestyle choices and environmental exposures that are known risk factors. Informed physicians will be able to provide care directed toward minimizing patients modifiable risk factors to lower incidence rate and routine imaging offered when there is an index of suspicion to minimize mortality rate in high-risk populations. This review highlighted practices such as circulating tumor DNA and a Ga-Alfatide II CT/PET scan that can be utilized to improve screening in the future and further dissected errors made in lung cancer diagnosis.