"About 42% of lung cancer patients do not live more than a year after diagnosis"
About 70% of lung cancer cases in Russia are detected only at stage III–IV, when the patient's chances of recovery are several times lower than with earlier diagnosis, said Marina Chernykh, Deputy Director for Radiological Treatment at the N.N. Blokhin National Research Medical Center of Oncology, chief freelance radiotherapist at the Ministry of Health. According to her, about 42% of lung cancer patients do not live even a year after diagnosis. Moreover, the disease has been asymptomatic for a long time. The doctor talks about how to reduce the risk of developing the disease, about modern methods of its treatment and diagnosis in an interview with Izvestia on the occasion of World Lung Cancer Day.
"A symptom that should be a reason for examination is often perceived as the norm"
— How often is lung cancer diagnosed in Russia? Have the statistics changed in the last 10-15 years?
— Every year in Russia, about 50-60 thousand new cases of tracheal, bronchial and lung cancers are detected. This indicator has been at about the same level for several years now. But the portrait of the patient is changing: the proportion of women is growing. This is not an accident, but a delayed echo. Men in Russia began to give up tobacco en masse and won earlier, while women smoked later. Decades pass between a cigarette and a diagnosis, so today's statistics reflect the effects of habits formed about 20 years ago. We will see the effect of quitting smoking with the same delay.
Marina Chernykh, Chief Freelance Radiotherapist at the Ministry of Health
— Lung cancer ranks first in the world in terms of mortality among oncological diseases. What is the situation in Russia — to what extent has it been possible to reduce mortality in recent years?
— Mortality from malignant neoplasms in Russia is generally decreasing: modern diagnostic and therapeutic methods significantly improve the prognosis of patients. But lung cancer still holds a sad primacy. There is an indicator that says a lot about this disease — a one-year mortality rate. According to data for 2025, about 42% of lung cancer patients do not live even a year after diagnosis. No other tumor gives such a figure.
At the same time, the indicator has decreased by almost 10% in ten years. That's a lot of progress. But we have not yet defeated the main cause of high mortality: about 70% of cases in Russia are detected at stage III–IV, when treatment options are limited, and the patient's chances are several times lower than when diagnosed at stage I–II.
— Is it true that lung cancer does not manifest itself at first? How to detect the disease at an early stage if nothing bothers a person?
— Yes, and this is the main trap of this disease. There are no pain receptors in the lung tissue, and the bronchi compensate for tumor growth for a long time. By the time complaints appear, the process is usually already beyond easy. It's pointless to wait for symptoms. The only method that has proven effective in early detection is screening programs for at—risk groups. These are primarily experienced smokers and workers in harmful industries.
Today, such examinations in the country mainly rely on fluorography and X-rays. The problem is the sensitivity of these methods: they simply won't show a small focus. Low-dose computed tomography (NDCT) of the chest shows formations several millimeters in size, under radiation exposure comparable to conventional X-rays. So far, NDKT screening is working at the level of individual regions. A city program for at-risk groups has been operating in Moscow for several years. The program in Krasnoyarsk and Tyumen has shown very good results. The Ministry of Health is considering the inclusion of NDT in the all-Russian medical examination for at-risk groups at the federal level. If this happens, the detection pattern of lung cancer will change dramatically.
— What symptoms should alert you? Are there any signs that many patients ignore?
— The first on the list is a cough. Not any one, but the one that doesn't last more than three weeks or has changed its character: it doesn't sound the same as usual. It is he who is ignored most often. "Smoker's cough" is a familiar explanation that a person and his environment can repeat for years until the condition becomes critical. Because of this, the symptom that was supposed to be the reason for the examination is perceived as the norm. This is one of the main reasons for late diagnosis. Further— it is even more alarming: hemoptysis, shortness of breath, disproportionate exertion when it is difficult for a person to climb to his floor or perform routine household chores, chest pain; recurring and difficult to treat pneumonia and bronchitis, severe weight loss and weakness. None of these signs in itself means cancer. But each of them is a sufficient reason to go to the doctor, and not wait until "it passes by itself."
"Secondhand smoke is a proven risk factor, not a hypothetical one"
— It is believed that lung cancer is most often found in smokers. Who else is at risk and which factors most strongly influence the development of the disease?
— Smoking remains the main and fully proven factor: it accounts for about 85% of cases. But the remaining 15% are also people at risk, and it's important to keep them in mind. These are workers of harmful industries who regularly come into contact with industrial carcinogens: gorenje products, asbestos, heavy metals. A separate category is patients with chronic lung diseases, primarily with COPD. Previously transferred radiation therapy to the chest area and burdened heredity increase the risk.
Therefore, "I don't smoke, so it doesn't concern me" is a very dangerous oversimplification.
— How harmful is secondhand smoke and electronic cigarettes?
— Secondhand smoke is a proven risk factor, not a hypothetical one. Numerous studies have shown that prolonged inhalation of other people's tobacco smoke statistically increases the likelihood of developing lung cancer in a non-smoker. That is why the ban on smoking in public places has significantly affected the incidence in those countries where it was introduced earlier and more consistently.
The story with e-cigarettes is different, and we need to be honest here. They appeared relatively recently. In order to confidently link the risk factor with the development of a malignant tumor, decades—long observations are needed - there is simply no such data on vapes yet. Liquids and aerosols contain substances with proven irritant and potentially carcinogenic effects on lung tissue. A reasonable position here is to treat e—cigarettes not as a safe alternative to conventional ones, but as a product with an insufficiently studied, but definitely non-zero risk.
— Many people believe that lung cancer is a verdict. Is this the case now?
— This idea is outdated, although it did not arise from scratch. Until relatively recently, the five-year survival rate for stage four lung cancer was close to zero, and the word "verdict" sounded accurate. Immunotherapy and targeted therapy have changed the picture. According to our observations, about 20% of patients, even with a common process, live for five years or longer. For this disease, we are no longer talking about a percentage improvement, but about a fundamentally different reality.
And if the tumor is detected at stage I–II, we can no longer talk about prolonging life, but about a full-fledged cure in a significant proportion of cases. The difference between a "verdict" and a curable disease today is most often determined not by the strength of the tumor, but by the stage at which it was found.
"Modern methods give a chance to catch the disease before the symptoms appear"
— What methods of lung cancer diagnosis and therapy are currently used in Russia? How effective are they?
— First, an important caveat: lung cancer is not a single diagnosis, but a group of diseases with different biology and very different scenarios of development. Two tumors may look similar, but behave completely differently. Therefore, molecular genetic testing has become the standard of diagnosis. It shows exactly which variant of the disease we are dealing with, and determines the choice of treatment. The range of therapeutic options has grown dramatically in recent years. If the tumor has a driver mutation, targeted therapy is used: the drug acts specifically on tumor cells, practically without affecting healthy tissues, and differs markedly from classical chemotherapy in tolerability.
Immunotherapy is increasingly being used. Checkpoint inhibitors remove the tumor's "disguise" from the immune system, either alone or in combination with chemotherapy. Antibody-conjugated drugs have also appeared that deliver cytostatics specifically into the tumor cell.
An innovation in recent years is computer systems for processing diagnostic images, including those using artificial intelligence. In a number of regions, they have already become part of routine practice and a support tool for the radiologist.
— How is AI used in the treatment and diagnosis of the disease? How important is his role, in your opinion?
— The main area of application of AI today is the analysis of diagnostic images. The algorithm identifies nodules in the lung tissue and draws the attention of the radiologist to them. This reduces the risk that a very small focus will be lost among the many images that the doctor looks at during the shift. Such systems have been operating in Moscow for several years now: they significantly unload radiologists and allow them, first of all, to send studies with suspicious findings for detailed analysis. This is especially important for regions where there are not enough radiologists.
At the same time, I would like to emphasize that AI is not an independent participant in the process and in no way replaces humans and clinical thinking. This is a second look — very attentive, never tired and completely independent. The final decision is always left to the individual. And responsibility too.
— How to reduce the risk of lung cancer? What are the most effective prevention methods?
— The first and most important thing is quitting smoking. The sooner the better: the risk begins to decrease from the very first years without cigarettes. Remember: it's not too late to quit at any age. The second is to minimize secondhand smoke, especially at home and in the workplace. The third is personal protective equipment and compliance with safety standards in hazardous industries. And separately — routine checkups. Modern methods such as NDKT offer a chance to catch the disease before symptoms appear, that is, when treatment works best.
None of these points guarantees absolute protection. But together they really change the statistics of both morbidity and survival.
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