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Ask the Experts Archive > Types of Cancer > Lung Cancers > General Concerns
Second Hand Smoke and Lung Cancer Risk and Screening
Affiliation: Abramson Cancer Center of the University of Pennsylvania
Last Modified: January 28, 2007
Dear OncoLink "Ask The Experts,"
I am a 37-year-old female non-smoker. Although I have never smoked, both my father (at age 51) and paternal grandmother (at age 72) died of lung cancer and smoked heavily. I was exposed to years of second-hand smoke, as I lived in the same house as my father for 12 years and he averaged 3-5 packs of cigarettes a day. Am I at high risk for developing lung cancer, and are there any screenings, such as CT scans, that I should be getting as a precaution?
Anil Vachani, MD, Attending Physician at the University of Pennsylvania Medical Center, responds:
The risk of developing lung cancer is highest in smokers and ex-smokers. This risk increases with increasing number of packs per day and greater total number of years one has smoked. Though the risk declines after tobacco cessation, it is still significantly higher compared to someone who is a life-long non-smoker. Approximately 85-90% of all lung cancer cases occur in current or ex-smokers.
Exposure to second-hand smoke likely raises the chance of lung cancer.
This increase is only about 20% greater than the risk of a non-smoker who has not been exposed to second-hand smoke. Therefore, the overall risk for this person is still very low.
Unfortunately, there are no approved methods for lung cancer screening, and no medical organizations currently recommend screening for lung cancer. Previous studies found that by the time a chest x-ray could detect a lung cancer, most patients had advanced disease, and screening with chest x-ray did not save lives. There is a large on-going study of screening for lung cancer that is evaluating the use of CT scans in smokers and ex-smokers, but results of this study will likely not be available for at least 5 more years. Preliminary reports of CT screening look promising, and have shown that CT can detect smaller tumors than x-ray. However, these studies have not included a control group of subjects that did not receive CT screening, and so we cannot determine if there was an improvement in mortality. The ongoing national trial is comparing people screened with chest x-ray to people screened with CT scan, and will be able to determine if there is lower mortality in patients screened with CT. If no advantage is found, then it would not be useful to perform lung cancer screening with CT.