Imagine the possibility of detecting lung cancer by using a simple blood test. At this time researchers are working on advancing biomarker studies towards this goal. The Congressionally Directed Medical Research Programs' Lung Cancer Research Program has funded The Detection of Early Lung Cancer Among Military Personnel consortium to investigate early detection biomarkers in lung cancer for Service Members.

I'm sure many have heard of lung cancer, but how many are aware that this is the most common cancer worldwide? As November is national Lung Cancer Awareness month, this provides a moment to stop and think about this epidemic throughout our country that is affecting so many lives.

Lung cancer is extremely difficult to detect, and affected individuals can be considered high-risk or low-risk. For those in the high-risk category (current or former smokers, family history, hazardous work environment, etc.), the current detection method includes a computed tomography scan or chest X-ray. Both of these diagnostic methods give increased levels of radiation exposure and can be inconclusive (giving a large percentage of false positives). In light of this, individuals with low-risk would not consider this as routine screening. Generally, an individual with a low-risk of lung cancer might not seek medical attention until symptoms begin to show, in which case, the cancer may be at a more advanced stage and more difficult to cure.

Lung cancer affects approximately 1.6 million people worldwide. This year in the U.S. alone, it is estimated that there will be 222,500 new cases of lung cancer, and 155,870 people will die from this disease. The leading cause of lung cancer is tobacco use, and 24 percent of Service Members smoke compared to 19 percent of civilians. In addition, deployments can worsen smoking rates by as much as 50 percent. Military service also leads to a wide range of occupational risks and exposures, such as diesel fuels, burn pits, uranium, and asbestos.

"Recognizing the risk factors that Service Members have for developing lung cancer is why it is imperative to support the research that will advance early detection, prevention, risk assessment, diagnosis and treatment," said Col. Wanda Salzer, CDMRP director. "The LCRP promotes the integration of research from multiple disciplines, collaborations between research scientists and clinicians, and supports new and early career investigators to pursue productive, impactful careers at the forefront of lung cancer research."

In response to the multiple risk factors for lung cancer in Service Members, as well as efforts by the lung cancer advocacy community, Congressional appropriations were provided to the CDMRP in 2009 to establish the LCRP.

"To achieve the LCRP's goal of eradicating deaths from lung cancer, the program has invested over $85 million in research," said Marielena McGuire, LCRP program manager.

"The LCRP encourages researchers to propose their best, innovative ideas that address the urgent need to eradicate deaths from lung cancer," she continued. "Scientists are challenged to pursue high-risk, high-reward research, explore new paradigms that could lead to critical discoveries and make an unprecedented impact on lung cancer."

McGuire explained that in 2010, the LCRP funded the DECAMP clinical consortium. The DECAMP consortium is led by Dr. Avrum Spira of Boston University Medical Campus and this consortium is conducting research studies to develop and validate early detection molecular biomarkers for lung cancer within current and former Service Members. This consortium is working in collaboration with four large military treatment facilities (San Antonio Military Medical Center, Walter Reed National Military Medical Center, Naval Medical Center Portsmouth, and Naval Medical Center San Diego), seven Department of Veterans Affairs hospitals, and several additional clinical sites.

"Lung cancer-associated mortality has remained essentially unchanged over the last three decades, in part because of our inability to detect lung cancer at its earliest and potentially curable stage. Broadly, DECAMP is advancing lung cancer research by discovering and validating minimally and non-invasive molecular biomarkers for the pre-clinical detection of lung cancer," said Spira.

"Already, we have recruited 375 of a targeted 500 patients in our diagnostic cohort of patients with indeterminate pulmonary nodules, and 472 of a targeted 800 patients in our longitudinal screening cohort of high-risk smokers. In addition, we are in the process of building and training molecular biomarkers in the nasal and bronchial epithelium capable of distinguishing patients with malignant and benign pulmonary nodules. We are also working to identify quantitative imaging features that can serve this same purpose. Excitingly, we have also discovered transcriptomic changes in endobronchial biopsies from lung cancer patients and controls that suggest an immunologic vulnerability to lung cancer development."

The need for lung cancer research is clear. The statistics alone provide enough detail to cause concern and promote a need for this awareness. Through the CDMRP supporting research such as the DECAMP consortium, we are able to provide our Service Members with assurance that medical research is working to support their medical needs. This scientific research focused on early detection of lung cancer will save the lives of our military and American public.

"The ultimate goal of the LCRP is to eradicate deaths from lung cancer," said McGuire.