Welch LS, et al. Occup Environ Med 2019;76:137–142. doi:10.1136/oemed-2018-105431

“Lung cancer is a leading cause of cancer death worldwide. Five-year survival is 19% for all lung cancers and 55% for localised tumours; average 5-year survival for advanced cases with metastases is only 4.5%. The International Agency for Research on Cancer lists 13 agents with high likelihood of causing lung cancer: ionising radiation, asbestos, silica, nickel, cadmium, chromium, beryllium, arsenic, diesel exhaust, soot, bis(chloro-methyl) ether, coal tar pitch and sulfur mustard. Studies also suggest that there is a more than additive interaction between asbestos and cigarette smoking; it is not yet established if this interaction exists for other lung carcinogens as well”

 Using criteria that include occupational risk Welsh and her colleagues have detected a baseline rate of lung cancer equivalent to that found in the US National Lung Screening Trial, although less than half the cohort met smoking criteria used in that trial.

Early detection of lung cancer in a population at high risk due to occupation and smoking

by Laura S Welch, John M Dement, Kim Cranford, Janet Shorter, Patricia S Quinn, David K Madtes, Knut Ringen.