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Early detection of lung cancer in a population at high risk due to occupation and smoking
- Source :
- Occupational and environmental medicine. 76(3)
- Publication Year :
- 2018
-
Abstract
- ObjectiveThe US National Comprehensive Cancer Network (NCCN) recommends two pathways for eligibility for Early Lung Cancer Detection (ELCD) programmes. Option 2 includes individuals with occupational exposures to lung carcinogens, in combination with a lesser requirement on smoking. Our objective was to determine if this algorithm resulted in a similar prevalence of lung cancer as has been found using smoking risk alone, and if so to present an approach for lung cancer screening in high-risk worker populations.MethodsWe enrolled 1260 former workers meeting NCCN criteria, with modifications to account for occupational exposures in an ELCD programme.ResultsAt baseline, 1.6% had a lung cancer diagnosed, a rate similar to the National Lung Cancer Screening Trial (NLST). Among NLST participants, 59% were current smokers at the time of baseline scan or had quit smoking fewer than 15 years prior to baseline; all had a minimum of 30 pack-years of smoking. Among our population, only 24.5% were current smokers and 40.1% of our participants had smoked fewer than 30 pack-years; only 43.5% would meet entry criteria for the NLST. The most likely explanation for the high prevalence of screen-detected lung cancers in the face of a reduced risk from smoking is the addition of occupational risk factors for lung cancer.ConclusionOccupational exposures to lung carcinogens should be incorporated into criteria used for ELCD programmes, using the algorithm developed by NCCN or with an individualised risk assessment; current risk assessment tools can be modified to incorporate occupational risk.
- Subjects :
- Male
medicine.medical_specialty
Lung Neoplasms
Population
Early detection
Risk management tools
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Occupational Exposure
medicine
Humans
030212 general & internal medicine
Lung cancer
education
Early Detection of Cancer
Aged
Neoplasm Staging
education.field_of_study
Lung
business.industry
Smoking
Public Health, Environmental and Occupational Health
Cancer
Middle Aged
medicine.disease
030210 environmental & occupational health
United States
medicine.anatomical_structure
Carcinogens
Female
Risk assessment
business
Lung cancer screening
Subjects
Details
- ISSN :
- 14707926
- Volume :
- 76
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Occupational and environmental medicine
- Accession number :
- edsair.doi.dedup.....715216d63c90b14117404fe35fdbd367