Lung cancer is the deadliest cancer in the U.S. and although new precision therapies have helped curb its high mortality rate, both smokers and nonsmokers continue to be diagnosed with various forms of this cancer due to commercial tobacco use, radon, air pollution and other drivers of the disease.
Preventive lung cancer screening, used to detect whether a tumor is beginning to grow, has been available for around a decade. The U.S. Preventive Services Task Force currently recommends adults between 50 and 80 who have a 20 pack-year smoking history and who currently smoke (or have quit within the past 15 years) receive a low-dose computed tomography (CT) every year.
Unfortunately, recent research from Fred Hutchinson Cancer Center found nearly half of people with “positive” lung cancer screening CTs, (and positive is not good in cancer) had delays in their follow-up. As a result, some of these people had their cancers diagnosed at a later stage. Early detection works best when any suspicious findings caught on a scan are investigated.
But what about people who don’t smoke but live or work or play around those who do?
A regular Fred Hutch News reader wondered if low-dose CT lung cancer screening was available for nonsmokers who grew up around people who smoked, a perfect question during November, Lung Cancer Awareness Month.
For answers, we tapped Fred Hutch pulmonologist and cancer prevention researcher Matthew Triplette, MD, MPH, who said this is not an uncommon question, but is one that “can be tough to give a satisfying answer to.”
“Essentially every test or procedure we do has both potential risks and potential benefits,” Triplette explained, going on to add low-dose CT screening for lung cancer has been demonstrated to be helpful in patients of a certain age with a personal high-risk smoking history, but that it has not yet been demonstrated to be equally helpful in other groups.
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“While we know family history and second-hand smoke can contribute to lung cancer risk, the highest risk group remains those with a substantial smoking history,” he said. “We definitely worry about the potential harms of screening people at lower risk for lung cancer including radiation risk and procedural harms.”
Currently, Triplette said low-dose CT screening is only recommended for people who meet the smoking criteria, but said the criteria is under continuous evaluation.
“This is definitely something that’s worth bringing up with your primary care physician and having a more personalized discussion about,” he added.
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Diane Mapes is a staff writer at Fred Hutchinson Cancer Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at email@example.com. Just diagnosed and need information and resources? Visit our Patient Care page.
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