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There are nearly two billion people in the Western Pacific Region () as designated by the World Health Organization (WHO), and they bore over one-third of all global cancer cases in 2020.

"Lung cancer was the most diagnosed cancer, accounting for 16.1% of all cases and almost a quarter of deaths (22.7%), the highest of any WHO-defined region," said Nicole M. Rankin, MSc, PhD, of the Melbourne School of Population and Global Health/University of Melbourne in Australia, and colleagues.

The group conducted a review of lung cancer in that area, looking at risk factors as well as primary and secondary prevention measures. Rankin's group reported in that:

• Smoking prevalence across the region was high, especially among males, with >50% prevalence in men in Papua New Guinea (2023 total population around 10 million) and the Solomon Islands (total 2023 population around 740,000).

• About 10-15% of lung cancer cases in the WPR were seen in people who did not smoke. Tuberculosis was a key risk factor in the Philippines and Papua New Guinea.

• WHO measures for smoking cessation have been implemented in 24 countries in the region. (MPOWER stands for Monitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco smoking; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; and Raise taxes on tobacco.)

• Lung cancer screening (LCS) is gaining ground in WPR, with a focus on specific target groups, such as those at high risk, Also, health provider education and integration of smoking cessation into LCS programs are helping. Still, "significant barriers to LCS uptake have been identified, including practical barriers (travel time and associated costs, work, and/or career responsibilities), and the impact of comorbidities, and emotional barriers (fear, shame, fatalism, avoidance, and low risk perception) inclusive of stigma," Rankin and colleagues wrote.

They stressed that to "enable equitable participation, LCS programs need to address age, sex differences, current and past smoking status, socioeconomic status, and geographical factors."

In recent VJ Oncology and eCancer videos, lung cancer specialists from other regions shared their thoughts on how lung cancer screening is being deployed in their countries.

David Baldwin, MD, Nottingham City Hospital, England: LCS in the U.K. has been helped by having a performed according to a national protocol, and this has resulted in a pretty rapid rollout of of screening so far, but especially considering that the program started just at the beginning of the .

So it didn't have a particularly great start -- it had to be paused at a lot of the centers -- but nevertheless, the coverage of the population is around 10-15% of the eligible population already ... There is a full roll-out planned so that all eligible people will have received their first scan by 2028.

What we've seen so far are some pretty impressive figures: 2,200+ cancers detected; 76% of these are at stage I and II, and the majority, in fact, are at stage I. The other thing that we've shown is that in lung cancer as a whole, the people in the most deprived groups, which have been targeted in the screening, now have the highest rate of stage I and II cancers -- and that's for lung cancer overall. It just shows you what a screening program can do if it targets the correct population (2023 World Conference on Lung Cancer, ).

Julie Barta, MD, Thomas Jefferson University, Philadelphia: In LCS, we focused a lot on race as a contributor to some of the differences in LCS outcomes. Certainly, the U.S. Preventive Services Task Force's expansion of was a good first step towards trying to improve health equity in terms of LCS.

However, there are a lot of other underserved populations that may be defined by differences in age or gender identities, sexual orientation, even geography. There are differences in LCS outcomes between rural and urban areas. These are all groups that we want to focus on in future studies.

I think the important LCS outcomes to look at are not only uptake of LCS, but also adherence with annual low-dose CT [LDCT] scans as well as short interval follow-up scans for patients who have suspicious nodules (2023 American Association for Cancer Research, ).

Marcelo Severino Imasa, MD, Lung Center of the Philippines, Manila: For lung cancer in the Philippines, what we've experienced so far is that we see most cases at advanced stage. [With LCS], individuals who have high risk, meaning these are smokers who are at least 50 years old, or may have a family history of having lung cancer, we encourage them to undergo LDCT.

The problem we have is disseminating information [about LCS]. Although the program has been running for a number of years, we have few takers, so it has to do with information being brought out of our hospitals to the local communities, and also identifying which individuals would qualify for [LCS]. We are hoping that, with programs such as [], we may be able to reach out to people (2023 ).

Kim Yeol, MD, PhD, National Cancer Center Korea, Goyang: I'm the in-charge person for supporting, operating LCS programs for ... heavy smokers. The is still high, and tobacco taxes are slightly lower compared to other developed countries. Recently we made some efforts to give out picture warnings on tobacco packs and increase the tobacco tax.

By a tax, we support smokers to quit smoking ... the pharmacologic therapy for smoking cessation is . Smokers can get pharmacological therapies and smoking-cessation counseling at every clinic in the Korean system.

The smoking rate has recently been decreasing in males, but the other problems are the alternative tobaccos -- such as electronic [cigarettes] -- the user rate is and we are preparing a warning, public awareness, about the harmfulness of that (2023 Southeast Asian Breast Cancer Symposium, ).

Read the study here.