Lung-cancer screens effective in asbestos-exposed smokers

By Reuters Staff

NEW YORK (Reuters Health) - 14/3/2019

Low-dose computed tomography (LDCT) screening can detect early lung cancers in smokers with a history of occupational asbestos exposure, new research shows.

But very low rates of malignancy in asbestos-exposed individuals with no other risk factors suggest screening is not worthwhile for this group, Dr. Patrick Maisonneuve of the European Institute of Oncology IRCCS in Milan, Italy, and colleagues conclude in Lung Cancer, online March 6.

Lung-cancer screening for heavy smokers over 50 reduces mortality by detecting lung cancers early, when they can be cured surgically, Dr. Maisonneuve and his team note.

To investigate whether LDCT screening would also benefit people exposed to asbestos on the job, the team analyzed data from two LDCT screening programs at the European Institute of Oncology Milan.

The authors matched 216 asbestos-exposed individuals to 216 unexposed controls by age, sex and history of smoking. Review of LDCT scans showed more pleural plaques, diaphragmatic pleural thickening and pleural calcifications in the asbestos-exposed group.

However, parenchymal and interstitial alterations were similar for the exposed and unexposed groups.

In a review of 16 studies that included the current report, the authors found lung-cancer detection rates were 0.81% in asbestos-exposed individuals, 0.94% in asbestos-exposed smokers and 0.11% in exposed non-smokers.

"Although LDCT screening is effective in detecting lung cancer in ever-smokers exposed to asbestos, we have found the screening for asbestos-exposed persons with no additional risk factors for cancer does not appear viable due to the low cancer detection rate," they conclude.


Lung Cancer 2019.

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