Identifying occupationally exposed populations for lung cancer screening: it is about time

Lung cancer is responsible for nearly one in five of all cancer deaths in the world and is the leading occupationally related cancer type.1 Tobacco smoke exposure contributes the most significant risk although in developed countries, occupational exposures are estimated to contribute to 10%–30% of all lung cancers.1 The International Agency for Research on Cancer recognises at least 13 occupational exposures that are associated with a raised risk of lung cancer and at least 6 of these (asbestos, arsenic, radon, polyaromatic hydrocarbons, silica and nickel) may have a more than additive (ie, synergistic) risk when combined with tobacco smoke exposure.1

The National Lung Screen Trial (NLST) demonstrated a 20.0% mortality reduction for lung cancer deaths with three screening rounds using low-dose CT (LDCT) of the chest.2 However, LDCT screening for lung cancer is only effective when a high-risk population is screened. The number of...

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