PolmoniAMO_INGL

11 PolmoniAMO provided by the National Social Security Institute (INPS) to individuals suffering from cancer, for example the Ordinary Disability Allowance (AOI) and the Incapacity Pension (PI). In terms of social security, lung cancer is associated with an increase in both AOI and PI [9] compared to other cancers such as breast and/or colorec- tal cancers , for which social security expenditure has decreased over time due to the decline in cases resulting from the implementation of effective screening initiatives. Furthermore, the collateral costs associated with lung cancer are not insignificant, in- cluding, for example, the time and money spent by relatives and friends of patients devoted to the care of their loved ones, which can consist of expenses unrelated to medical treatment and hospitalisation, such as transport costs and home care, among other things. Direct and indirect healthcare costs are heavily influenced by the stage of the disease . One need only consider that the average wage loss of a stage IV lung cancer patient is almost five times higher than that of a stage IIIB patient (€ 2,282 vs. € 499; p=0,0135). The same applies to the out-of-pocket expenses that a stage IV patient (€ 5,295) and his or her caregiver (€ 4,319) have to bear compared to a stage IIIB patient (€ 3,528) and his or her caregiver (€ 2,232) [10]. These data suggest that a delay in the period between diagnosis and surgical, chemo- and radio-therapeutic treatment not only has a negative impact on survival but also on the quality of life and productivity of patients and their caregivers. A late diagnosis not only means treating an advanced disease with reduced chances of recovery, but also results in higher socio-economic costs both individually and for society as a whole. Earlier diagnoses of lung cancer through screening will increase the number of people who can return to work, thereby reducing the socio-economic costs re- sulting from the loss of productivity of individuals and the somewhat immea- surable collateral expenses incurred by family and friends of the patient [11]. 1.2 Treat earlier to treat better The disappointing five-year survival estimates for lung cancer patients can largely be at- tributed to the high proportion of individuals diagnosed when the disease is at an ad- vanced stage (65% in stages IIIA, IIIB and IV). In contrast, only 14% of patients are diagnosed with stage IA lung cancer, with associated five-year survival rates of 92% [12,13]. Lung cancer, like all tumours, is time-dependent. A late diagnosis re- duces the effectiveness of treatments; on the other hand, an early diagnosis increases life expectancy[14]. Screening can facilitate the early detection of cancer, thus expanding the treatment options available to the patient. Never before has the therapeutic arsenal available to cancer clinicians been so promising. Precision oncology has revolutionised the approach to the diagnosis and treatment of lung cancer.