Lung Cancer Screening for Asbestos-Exposed Workers?

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  Lung cancer screening with low-dose computed tomography for current and former long-term cigarette smokers has been endorsed by many organizations including the US Preventive Services Task Force (USPSTF), the American College of Chest Physicians, the American Society of Clinical Oncology, the American Thoracic Society, the American Association for Thoracic Society, the American Cancer Society and the National Comprehensive Cancer Network (1). USPSTF's recommendation is summarized in Box 1. Some organizations only recommend screening up to age 75. Effective February 15, 2015, Medicare began to cover the cost for lung cancer screening of individuals 55 to 70 years old who meet the cigarette smoking criteria in Box 1. What about individuals who have been exposed to workplace lung carcinogens? Should they be screened for lung cancer? Individuals with asbestos exposure who also smoked cigarettes are at appreciably higher risk of lung cancer because of synergism between asbestos and cigarette smoke compared to individuals who only smoked cigarettes. What special consideration should be given to these particularly high-risk individuals? Ideally one would answer this question by designing a randomized clinical trial among individuals with varying levels of exposure to occupational lung carcinogens. No such trials exist. However, an alternative approach would be to extrapolate the findings from the National Lung Cancer Screening Trial to individuals with exposure to workplace lung carcinogens who exhibit the same level of lung cancer risk as the 30- pack-year smokers for whom annual screening is recommended. A major difficulty for a clinician trying to decide if a patient should be screened is determining the extent of exposure an individual patient has to an occupational lung carcinogen. For cigarettes, clinicians can easily calculate pack-years. However, for other known lung carcinogens such as asbestos, clinicians have no easy way to estimate their patient's exposure. Determining air levels of carcinogens and years of exposure may be difficult because of a worker's variation in jobs held over a working lifetime. Furthermore, the reduction in workplace exposures since the 1980s due to improved engineering controls, increased use of respiratory protection equipment and reduced use of asbestos make extrapolation of lung cancer risk from older to present day workers difficult. [Description provided by NIOSH]
• Subjects:
  Asbestos Carcinogens Inorganic Chemicals Lung Lung Diseases Neoplasms Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Safety Smokers Tobacco Products

  More +
• Keywords:
  Asbestos Workers Cigarette Smoking Clinical Tests Lung Cancer Medical Screening Occupational Exposure
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  26
• Issue:
  3
• NIOSHTIC Number:
  nn:20054614
• Citation:
  Project S.E.N.S.O.R. News 2015 May; 26(3):1-4
• Contact Point Address:
  MSU-CHM, 117 West Fee Hall, East Lansing, MI 48824-1316
• CAS Registry Number:
  Asbestos (CAS RN 1332-21-4)
• Federal Fiscal Year:
  2015
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fffa8db938d908cd98de4d03ecdcc8af233915f3c549505fb46d0f06dc9b288912c5afbecd8a8a1b22f2b7e2b294d81649c7a3b7723f40419a34f659cf95f663
• Download URL:
  https://stacks.cdc.gov/view/cdc/217111/cdc_217111_DS1.pdf
• File Type:
  [PDF - 346.25 KB ]