HealthView column: The latest in lung health — risk factors and screening guidelines
Patients who meet the following screening guidelines are encouraged to be screened annually for lung cancer:
• 55-77 years of age with no signs or symptoms of lung cancer
• Have a tobacco smoking history of at least 30 pack-years (Pack years are calculated by multiplying the number of packs smoked per day by the number of years. For example, two packs per day for 15 years equals 30 pack-years)
• Current smoker, or one who has quit smoking in the last 15 years
November is Lung Cancer Awareness Month. Lung cancer is the leading cause of cancer deaths among both men and women in the United States.
At The Lung Center at Valley View, I see patients for a variety of pulmonary-related reasons, including shortness of breath, cough or an abnormal chest X-ray. We’re fortunate that lung cancer rates in Colorado’s intermountain region are falling. Lung cancer rates in Garfield, Pitkin, Eagle, Grand and Summit counties have declined from 37.1 per 1,000 people in 2014-2015, to 23.5 in 2015-2016, according to the most recent data available from the Colorado Health Institute. Still, for serving a community of this size, I do see a fair amount of lung cancer cases.
Findings from a recent study have further demonstrated that low-dose screening among men with no symptoms of lung cancer but a high risk for lung cancer led to a 26 percent reduction in lung cancer deaths after 10 years of follow-up. In a smaller study of women, the results were even more remarkable.
If you are a smoker over the age of 55, it’s incredibly important to come in for an annual screening. Symptoms of lung cancer can take years to notice, and the earlier we can address a nodule on a routine screening the better the outcome. We then schedule a screening for the following year so the appointment is not missed, and patients are not burdened with remembering to schedule. The type of low-dose CT scan that is recommended for lung cancer screening is a newer type of CT scan using approximately five times less radiation than a conventional CT scan.
There are many risk factors associated with lung cancer, with tobacco smoking being the highest. Currently, the percentage of tobacco smokers in Garfield County is higher than the state average. Both Valley View and Garfield County Public Health offer evidence-based tobacco cessation programs, and I encourage all current smokers to make a commitment to your health and quit. Further, there is no risk-free level of secondhand smoke. Since 1964, approximately 2,500,000 nonsmokers have died from health problems caused by exposure to secondhand smoke. The only way to fully protect nonsmokers against the damaging effects of smoke is to eliminate smoking in all homes, worksites and public spaces.
Because tobacco smoking is a potent carcinogen, secondary causes of lung cancer are often diminished in perceived importance. Radon exposure (a radioactive, odorless chemical element prevalent in a lot of older homes in Garfield County) is another risk factor I see in my practice. The Garfield County Public Health Department provides free radon home testing kits at their office next to Valley View Hospital. This time of year is a great time to test your home as it needs to be completed during colder months when windows and doors are closed. The tests are easy to administer, and results come back within a matter of weeks.
Additionally, I see occupational exposure to lung cancer-causing agents such as silica and asbestos in mining and construction workers. If you or a loved one is in one of these industries, please consider speaking with your primary care physician on the best ways to mitigate your exposure.
Suresh Khilnani, MD is a pulmonologist at The Lung Center at Valley View. For more information on lung health, call 970-384-7707 or visit vvh.org/the-lung-center.