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Lung Cancer Screening in Asbestos-Exposed Populations

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  • Steven B. Markowitz

    (Barry Commoner Center for Health and the Environment, City University of New York, New York, NY 11376, USA)

Abstract

Asbestos exposure is the most important cause of occupational lung cancer mortality. Two large randomized clinical trials in the U.S. and Europe conclusively demonstrate that annual low-dose chest CT (LDCT) scan screening reduces lung cancer mortality. Age and smoking are the chief risk factors tested in LDCT studies, but numerous risk prediction models that incorporate additional lung cancer risk factors have shown excellent performance. The studies of LDCT in asbestos-exposed populations shows favorable results but are variable in design and limited in size and generalizability. Outstanding questions include how to: (1) identify workers appropriate for screening, (2) organize screening programs, (3) inform and motivate people to screen, and (4) incorporate asbestos exposure into LDCT decision-making in clinical practice. Conclusion: Screening workers aged ≥50 years with a history of ≥5 years asbestos exposure (or fewer years given intense exposure) in combination with either (a) a history of smoking at least 10 pack-years with no limit on time since quitting, or (b) a history of asbestos-related fibrosis, chronic lung disease, family history of lung cancer, personal history of cancer, or exposure to multiple workplace lung carcinogens is a reasonable approach to LDCT eligibility, given current knowledge. The promotion of LDCT-based screening among asbestos-exposed workers is an urgent priority.

Suggested Citation

  • Steven B. Markowitz, 2022. "Lung Cancer Screening in Asbestos-Exposed Populations," IJERPH, MDPI, vol. 19(5), pages 1-15, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2688-:d:758570
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    References listed on IDEAS

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    1. Kevin ten Haaf & Jihyoun Jeon & Martin C Tammemägi & Summer S Han & Chung Yin Kong & Sylvia K Plevritis & Eric J Feuer & Harry J de Koning & Ewout W Steyerberg & Rafael Meza, 2017. "Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study," PLOS Medicine, Public Library of Science, vol. 14(4), pages 1-24, April.
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    Cited by:

    1. Khan, Abir & Sapuan, S.M. & Yusuf, J. & Siddiqui, Vasi Uddin & Zainudin, E.S. & Zuhri, M.Y.M. & Tuah Baharuddin, B.T. Hang & Ansari, Mubashshir Ahmad & Rahman, A. Azim A., 2023. "An examination of cutting-edge developments in Bamboo-PLA composite research: A comprehensive review," Renewable and Sustainable Energy Reviews, Elsevier, vol. 188(C).
    2. Sébastien Gendarme & Jean-Claude Pairon & Pascal Andujar & François Laurent & Patrick Brochard & Fleur Delva & Bénédicte Clin & Antoine Gislard & Christophe Paris & Isabelle Thaon & Helene Goussault &, 2022. "Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects," Post-Print hal-03783819, HAL.
    3. Olivia Pérol & Nadège Lepage & Hugo Noelle & Pierre Lebailly & Benoit de Labrusse & Bénédicte Clin & Mathilde Boulanger & Delphine Praud & Françoise Fournié & Géraud Galvaing & Frédéric Dutheil & Brig, 2023. "A Multicenter Study to Assess a Systematic Screening of Occupational Exposures in Lung Cancer Patients," IJERPH, MDPI, vol. 20(6), pages 1-15, March.

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