Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;202(5):649-655.
doi: 10.1007/s00408-024-00736-9. Epub 2024 Aug 20.

Examination of Firefighting as an Occupational Exposure Criteria for Lung Cancer Screening

Savan K Shah  1 , Seungjun Kim  1 , Arsalan A Khan  1 , Vaishnavi Krishnan  1 , Ann M Lally  1 , Palmi N Shah  2 , Gillian C Alex  1 , Christopher W Seder  1 , Michael J Liptay  1 , Nicole M Geissen  3
Affiliations

Examination of Firefighting as an Occupational Exposure Criteria for Lung Cancer Screening

Savan K Shah et al. Lung. 2024 Oct.

Erratum in

Abstract

Purpose: Firefighting is known to be carcinogenic to humans. However, current lung cancer screening guidelines do not account for occupational exposure. We hypothesize that firefighting is an independent risk factor associated with the development of high-risk lung nodules on low-dose CT (LDCT).

Methods: Members of a firefighter's union underwent LDCT at a single institution between April 2022 and June 2023 within a lung cancer screening program. Results were interpreted by designated chest radiologists and reported using the Lung-RADS scoring system. Demographic and radiographic data were recorded, and summary statistics are reported.

Results: 1347 individuals underwent lung cancer screening, with a median age of 51 years (IQR 42-58), including 56 (4.2%) females. Overall, 899 (66.7%) were never smokers, 345 (25.6%) were former smokers, and 103 (7.7%) were current smokers. There were 41 firefighters (3.0%) who had high-risk (Lung-RADS 3 or 4) nodules requiring intervention or surveillance, of which 21 (1.5%) were Lung-RADS 3 and 20 (1.5%) that were Lung-RADS 4. Of the firefighters with high-risk nodules, only 6 (14.6%) were eligible for LDCT based on current screening guidelines. There were 7 high-risk nodules (0.5%) that required procedural intervention, 6 (85.7%) of which were from the non-screening eligible cohort. There were also 20 never-smoking firefighters (57.1%) with high-risk nodules that were non-screening eligible.

Conclusion: Firefighting, even in the absence of smoking history, may be associated with the development of high-risk lung nodules on LDCT. Carefully selected occupational exposures should be considered in the development of future lung cancer screening guidelines.

Keywords: Firefighting; Low-dose CT; Lung cancer; Lung cancer screening; Occupational exposure.

PubMed Disclaimer

References

    1. Islami F, Ward EM, Sung H et al (2021) Annual report to the nation on the status of cancer, Part 1: national cancer statistics. J Natl Cancer Inst 113(12):1648–1669. https://doi.org/10.1093/jnci/djab131 - DOI - PubMed - PMC
    1. Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660 - DOI - PubMed
    1. Institute NC. SEER*Explorer: An interactive website for SEER cancer statistics. https://seer.cancer.gov/statistics-network/explorer/
    1. Walter FM, Rubin G, Bankhead C et al (2015) Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. https://doi.org/10.1038/bjc.2015.30 - DOI - PubMed - PMC
    1. Aberle DR, Adams AM, Berg CD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365(5):395–409. https://doi.org/10.1056/NEJMoa1102873 - DOI - PubMed

LinkOut - more resources