Hospitals in China 'lagging behind' on genetic tests for lung cancer

PUBLISHED : Tuesday, 05 November, 2013, 4:17am
UPDATED : Tuesday, 05 November, 2013, 4:27am

Fewer hospitals in China conduct genetic tests on lung cancer patients compared to Western countries, even though Asians are genetically more susceptible to the disease, a leading cancer expert has warned.

Speaking days after he chaired the 15th World Conference on Lung Cancer in Sydney, Professor Tony Mok Shun-kam, from Chinese University, told the South China Morning Post that more than 30 per cent of lung cancer cases in Asians could be attributed to mutated genes, compared with just 10 per cent in Western countries.

But, despite lung cancer being the No 1 killer disease in China, only 20 per cent of lung cancer patients on the mainland and 60 per cent in Hong Kong undergo a genetic test after being diagnosed with the illness, he said.

In most developed countries in the West, a genetic test for lung cancer patients is carried out automatically.

The discrepancy means patients in China miss out on gene-targeted treatment that is more effective and has fewer side effects than conventional chemotherapy.

Mok said more education was needed among the city's medical professionals in order for genetic testing to be increased.

Most patients who have the disease because of genetic factors have so-called EGFR (epidermal growth factor receptor) mutation in their genes, which can be treated by TKI (tyrosine kinase inhibitors) therapies.

All public hospitals in Hong Kong have the means to provide TKI therapies if the cause is genetic, and such treatment could cut the rate of the disease recurring by 84 per cent and increase life expectancy threefold compared to chemotherapy. There are four lab centres in Hong Kong that carry out the genetic tests and about 80 on the mainland. He said the procedure was not complicated, but medical workers needed extra training.

"Many medical staff only take a small sample size of lung tissue from a patient for a conventional test on the tumour," he said, adding that in many cases the sample was not sent for a genetic test or could be too small to enable one.

During the conference last Wednesday, Mok - the first Chinese national to chair the event - disclosed that he was conducting a clinical study on diagnosing the mutated gene by taking blood samples. He said that although the method was not currently as accurate as a genetic test, it was less invasive and could be used to augment genetic testing. Mok said he believed Asia, and especially China, could be one of the most important centres for global studies of lung cancer.

"Two decades ago when world experts mentioned Asian experts on lung cancer, they would only think of Japan," Mok said. But in recent years many leading names in China had carried out important research and achieved a global platform.

The number of people killed by lung cancer on the mainland has risen by 465 per cent in three decades, and it has replaced liver cancer as the top tumour killer, according to 2011 official figures.

The World Health Organisation said China would have the world's highest number of lung cancer patients, one million a year, by 2025. In Hong Kong there are over 4,000 new cases a year.