Non-small cell lung cancer: epidemiology, screening, diagnosis, and treatment

Lung cancer is the most common cancer worldwide and is also one of the leading causes of cancer related deaths. The 5-year survival rate depends largely on stage at diagnosis. Multiple large randomized controlled trials have demonstrated the clinical utility of lung cancer screening. Low dose computed tomography is recommended for lung cancer screening in several guidelines. Lung cancer is often diagnosed at more advanced stages owing to the nonspecific symptoms with which it presents. Diagnosis relies primarily upon imaging and biopsy. Diagnosis and staging should be performed simultaneously, if possible, by performing a biopsy at the site that will confer the highest stage. Sufficient material should be obtained to allow for molecular testing. Liquid biopsy may have a complementary role in detecting actionable mutations in non-small cell lung cancer. Treatment is predicated upon stage and may involve surgery, targeted chemotherapy, radiation therapy, immunotherapy, or some combination thereof.