2020 Health Care Professionals Guide [Update] 2020 VOL 2 [Update]: September | Page 9

At the time of diagnosis , approximately 79 percent of lung cancers have either spread to regional lymph nodes ( 22 %) or metastasized ( 57 %). 6 National efforts to increase low-dose computed tomography ( LDCT ) screening should significantly improve survival rates . The U . S . Preventive Services Task Force ( USPSTF ) recommends annual
The National Comprehensive Cancer Network guidelines recommend LDCT screening beginning at age 50 for individuals with at least 20 pack-years of exposure if they have documented high radon exposure .
screening for lung cancer with LDCT screening in adults ages 55 to 80 who have a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years . 8 Furthermore , the National Comprehensive Cancer Network ( NCCN ) guidelines recommend LDCT screening beginning at age 50 for individuals with at least 20 pack-years of exposure if they have documented high radon exposure . 9 The USPSTF and NCCN do not recommend LDCT screening after a person has not smoked for 15 years . 8 , 9 Because patients turn to their health care provider for guidance on cancer prevention , interviews for LDCT screening eligibility present opportunities to educate the public about the risks posed by smoking and radon , even if a person is not eligible for the screening .

RadonHealth Risks for Individuals Who Have Never Smoked

In addition to educating patients who are current or former smokers , a rigorous radon education effort is needed for patients who have never smoked tobacco products . A “ never smoker ” refers to an individual who has smoked fewer than 100 cigarettes in his or her lifetime . While health care providers encounter fewer lung cancer patients in their practice who never smoked as compared to those
If considered its own disease category , lung cancer in individuals who have never smoked tobacco products ranks among the top 10 causes of cancer mortality in the United States . Radon is the leading cause of lung cancer among individuals who have never smoked .
who have smoked , it is noteworthy that lung cancer in “ never smokers ” is in the top 10 causes of cancer mortality in the United States . Each year , 16,000 to 24,000 Americans die of lung cancer even though they have never smoked . 10 Protracted radon exposure is the leading cause of lung cancer in individuals who have never smoked . 7

The Science Behind the Risk Estimates

Radon is one of the earliest described human carcinogens . Carl Lebrecht Schefflers ’ s seminal 1770 publication on the health of underground miners in Schneeberg and Annaberg , in present-day Austria , provided an early description of morbidity likely attributable to radon gas exposure . 11 However , it was not until the 19th century that the disease was established as lung cancer , and reports later in the 20th century linked radon exposure to lung cancer during underground uranium and hard-rock mining . 11 In 1988 , the International Agency for Research on Cancer listed radon as a known human carcinogen . 12
Radon is one of the most comprehensively investigated human carcinogens . Laboratory studies have documented that an alpha particle ( e . g ., from radon decay products polonium-218 and polonium-214 ) can cause both single- and double-strand DNA breaks and can produce indirect genotoxic and nongenotoxic effects on both traversed and neighboring non- traversed cells . Experimental animal exposures to radon clearly demonstrate that radon decay products cause lung cancer . 7
Reducing the Risk from Radon | AGuide for Health Care Providers