SUMMARY
Mayo Clinic researcher David E. Midthun, M.D., has focused on lung cancer in clinical practice and research for more than 30 years and has worked on evolving areas of lung cancer screening and treatment since the early days of the field. His areas of expertise include lung cancer screening, risk assessment for lung cancer, and lung cancer diagnosis and staging.
Dr. Midthun has led or co-led multiple major lung cancer research protocols, including Mayo Clinic's seminal CT lung screening trial, the National Cancer Institute's National Lung Screening Trial, and the National Heart, Lung, and Blood Institute's National Emphysema Treatment Trial.
He directs the Mayo Clinic Lung Screening Program, a multidisciplinary effort involving regional community practices in Southern Minnesota and Wisconsin in addition to Mayo Clinic's campuses in Arizona, Florida, and Minnesota. The program team has screened more than 20,000 patients at eight sites. Dr. Midthun is also dedicated to educating the next generation of lung health experts. He directed the second-year pulmonary pathophysiology course at Mayo Clinic's medical school for 20 years.
Focus areas
- Lung cancer screening and nodule evaluation. Dr. Midthun is the site principal investigator for the Cancer Screening Assay Using DELFI (CASCADE-LUNG) study and the Screening for High Frequency Malignant Disease (SHIELD) study. These studies assess the use of blood tests to screen for lung cancer in patients who are undergoing CT screening.
- Screening disparities. Dr. Midthun is co-principal investigator of the Promoting Equity Through Multicomponent Strategies for Cancer Screening (PREMI) study, which is an R01 looking at disparities in lung cancer screening.
- Proteomic nodule classification. Dr. Midthun is the site principal investigator for the ALTITUDE study, a multicenter, randomized, controlled trial prospectively evaluating the clinical utility of the Nodify XL2 proteomic classifier in incidentally discovered, low to moderate risk lung nodules.
Significance to patient care
Dr. Midthun's biggest contribution to patient care has been to help show that it's possible — and important — to find lung cancer early. To do this, he has used CT scans and studied genetic changes in airway cells and blood. Early study results showed that the use of low-dose CT scans for screening could be promising.
Dr. Midthun worked with Stephen J. Swensen, M.D., on the Mayo Lung Screening Study, which tested CT scans from 2005 to 2009 in 1,520 people who were at high risk of lung cancer. This study showed the need for a larger trial.
Dr. Midthun then served as the co-principal investigator for the National Lung Screening Trial (NLST). The NLST involved more than 53,000 people who were at high risk of lung cancer, including more than 1,200 participants from Mayo Clinic. The study compared low-dose CT scans to chest X-rays. It showed a 20% reduction in lung cancer deaths, proving that CT scans save lives. The Mayo Clinic team also worked on finding blood-based markers to help decide who should be screened, to reduce unnecessary tests for those with noncancerous nodules and to speed up treatment for people with early-stage cancers.