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Lynne Eldridge MD

Lung Cancer Screening Should We Include Asbestos-Exposed People as Well?

By July 29, 2013

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Even though progress seems slow when it comes to lung cancer, some significant advances have taken place in just the last few years. And one of these is early detection with low-dose CT screening.

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Unfortunately, unlike Pap smears for detecting cervical cancer, and colonoscopies to detect precancerous polyps and early colon cancers, lung cancer screening is recommended only for certain people. To be exact - people between the ages of 55 and 74, who have at least a 30 pack-year history of smoking, and who continue to smoke or have quit in the past 15 years.

But we know lung cancer hits those who have never even smoked. A fifth of women who get lung cancer have never puffed on a single cigarette. Anybody with lungs can get lung cancer. We also know there are other risk factors besides smoking, such as radon exposure in the home, and asbestos exposure. Sadly, there aren't any guidelines on when to worry or get a screening test if you have those other risk factors.

An excellent example is those people who have been exposed to asbestos. Most exposures to asbestos occur on-the-job, for example, among those who work in construction. But non-occupational exposures can occur as well, for example, among those who embark on a do-it-yourself remodeling job in a home built between 1930 and 1950.

But when is asbestos exposure a danger?

Most of the information we have on asbestos comes from those who have had long term exposures at work. But no level of exposure is considered safe. In fact, mesothelioma - a cancer which begins in the membranes lining the lungs - has occurred in people who have only been exposed for a few days.

Back to screening.

Since asbestos can cause lung cancer as well as cancer in the lung lining (the pleura), how can people be checked out to hopefully find these cancers in the earlier more curable stages? While The Agency for Toxic Substances and Disease Registry has put forth Clinical Screening Guidelines for Asbestos-Related Disease, these do not include routine CT screening such as that recommended above for smokers.

Why is that important? One study found that CT screening for lung cancer in asbestos workers was at least as useful in detecting lung cancer in the early stages as it was for heavy smokers.

What's the take home?

For those of you who may have asbestos in your home? The best advice is to leave it alone. Unless it's tampered with, asbestos insulation poses little risk. But if you've been dying to knock down a wall or update your home, find an asbestos professional to do the job.

If you've been exposed to asbestos at work, talk with your doctor. And first, make sure you find a doctor who is familiar with asbestos-related disease. If I were to venture a guess by looking at the studies to date, I suspect CT screening for lung cancer will be recommended for asbestos workers in the future. But this is your life today. Talk to your doctor and share the studies to date (there are hyperlinks to the abstracts at the bottom of the article below on asbestos dangers.)

Learn more about the cancers and medical conditions caused by asbestos, and what you can do if you are exposed:

Photo: istockphoto.com

Comments
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