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Test identifies smokers at highest risk
Scientists using a genetic-based approach have found a method for identifying cigarette smokers with the highest risk of developing lung cancer.

Researchers from Boston University School of Medicine and the University of Utah say they used "a genomic approach to prevent lung cancer in these individuals and to personalise cancer chemoprophylaxis and therapy."

Their study appears in the latest edition of the journal Science Translational Medicine.

While 10% to 20% of smokers develop lung cancer in their lifetime, there have been no tools available to identify which of the approximately 90 million current and former smokers in the United States are at the highest risk, the researchers say.

Usually the diagnosis is made at a very advanced stage where treatment is largely ineffective.

Study lead author Associate Professor Avrum Spira of Boston University says the new method relies on a gene expression-based biomarker that distinguishes smokers with and without lung cancer.

The scientists located a "cancer-related pathway" called PI3K, activated in the cells that line the airway of smokers who have lung cancer.

"This finding is significant as these cells can be obtained in a relatively non-invasive fashion from the airway of smokers at risk for lung cancer, and does not require invasive sampling of lung tissue where lung tumours normally arise," says Spira.
Tailored treatment

The data also suggests that by measuring the gene expression activity, doctors can help determine which specific cancer pathways have been deregulated within an individual smoker, allowing one to tailor a specific drug to reduce that individual's risk of lung cancer.

"This represents a critical advance in the field of lung cancer prevention as there are currently no effective strategies for lung cancer prevention among high risk smokers," Spira says.

The researchers say the work could "help address the enormous and growing public health burden associated with lung cancer, the leading cause of cancer-related death among men and women in the US and the world."

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