Nonsmoking, asbestos-exposed people still at risk of lung cancer

Individuals who are exposed to asbestos are at higher risk of lung cancer despite modest exposure to tobacco, reveals a recent study.

“Low-dose computed tomography (LDCT) screening is effective at identifying early-stage lung cancer in this population and existing lung cancer risk criteria do not capture this population adequately,” the researchers said.

This study included 1,743 participants from the Western Australia Asbestos Review Program, an asbestos health surveillance program, who underwent at least one LDCT scan and lung function assessment as part of an annual review between 2012 and 2017. The research team confirmed lung cancer cases through linkage to the registry and calculated the theoretical eligibility for different screening programs.

The participants (median age 69.8 years, 85.0 percent male, 65.8 percent ever-smokers) underwent a total of 5,702 LDCT scans. Twenty-six lung cancers were detected overall (1.5 percent of the population, 3.5 cases per 1,000 person-years of observation).

Lung cancer was in its early stage in majority of the patients (86.4 percent), of whom four (15.4 percent) were never smokers.

Notably, nearly three of four individuals in this population (n=1,299, 74.5 percent), including the majority of lung cancer patients (n=17, 65.4 percent) would not have been eligible for lung cancer screening based on the current screening program criteria.

“Asbestos is a major risk factor for lung cancer, with or without tobacco smoke exposure,” the researchers said. “LDCT screening for early lung cancer is effective but only when targeting high risk populations.”