A Nasal Swab May Be the New Diagnostic Tool of Choice for Lung Cancer

A recent study published in the Journal of the National Cancer Institute has shed light on a potential new diagnostic measure for lung cancer that is less invasive and less expensive than traditional means. This diagnostic tool is actually a simple nasal swab for at risk patients.

How Does the Nasal Swab Work?

Traditionally, lung lesions, called solitary pulmonary nodules, are found during chest X-rays for other conditions, not related to lung cancer. When these nodules are found, especially in patients who are at risk for lung cancer, the next steps can be intense. Surgical lung biopsies as well as further imaging typically follow, which are both invasive, and expensive. While normally this wouldn’t be a negative experience in the long run, if it lead to an early diagnosis of lung cancer, it is actually estimated that nearly 95% of those who go through further screening measures for their nodules receive benign (not cancerous) results.1 This high number means that many people are potentially undergoing elaborate testing measures that are not needed.

Researchers out of the Boston University School of Medicine (BUSM) have found a connection between genomic biomarkers in the nasal epithelium (the membrane in the nasal cavity) and lung or nodule tissue used for lung cancer diagnosis. They propose that these nasal cells can contain the same genetic signatures as cancerous cells biopsied from the lungs, and thus, can be used as a diagnostic measure for lung cancer. Two clinical trials, called the Airway Epithelium Gene Expression in the Diagnosis of Lung Cancer, were conducted on individuals at risk for lung cancer, specifically using smokers or individuals with a history of smoking. The nasal epithelium cells in these populations were found to be sufficient to positively identify the presence of cancer.

“Our findings clearly demonstrate the existence of a cancer-associated airway field of injury that also can be measured in nasal epithelium. We find that nasal gene expression contains information about the presence of cancer that is independent of standard clinical risk factors, suggesting that nasal epithelial gene expression might aid in lung cancer detection. Moreover, the nasal samples can be collected non-invasively with little instrumentation or advanced training.”
-Marc Lenburg, PhD, Professor of Medicine at BUSM and Co-Senior Author2

When Will This Test Be Available to the Public?

While the results can really only be generalized to the studied population, those with a history of smoking, they do indicate that there is a potential for using these nasal cells as opposed to long-term, expensive, stressful, potentially risky, and invasive traditional methods like surgery or further scanning.

“There is a clear and growing need to develop additional diagnostic approaches for evaluating pulmonary lesions to determine which patients should undergo CT surveillance or invasive biopsy. The ability to test for molecular changes in this ‘field of injury’ allows us to rule out the disease earlier without invasive procedures.”
-Avrum SPira, MD, MSc, Professor of Medicine, Pathology, and Bioinformatics and BUSM and Corresponding Author3

Further investigation needs to be done to determine the true efficacy of the nasal swab technique, and to determine if it can be a reliable predictor for those without a history of smoking.

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