Low-dose chest CT for lung cancer screening in never-smokers

Can we use low-dose chest computed tomography (CT) for lung cancer screening in selected never-smokers?

Julian Dobranowski, MD: If we look at the definition of screening from a social economic perspective, we have to look at what the effect of the screening is for the general population and who is at high risk for lung cancer to have the screening.

The original National Lung Cancer Screening [Trial] looked at patients that were between 55 and 74 years of age and had a minimum of 30 years of smoking experience. The epidemiological information that we have, the statistics that we had pertains to that demographic group. But we can extrapolate information from that that also pertains to never-smokers.

To assess whether a patient is eligible for lung cancer screening that was never smoking, it would require taking a risk assessment examination—and these are available online. The one I am familiar with has been written and published by Martin Tammemägi from Brock University (see more at brocku.ca). This takes into consideration the patient’s age, education, body mass, personal history of cancer, family history of cancer, and then gives you a risk assessment. Any risk assessment over 2 would be valid for lung cancer screening.

I personally took the risk assessment and my score was 0.001, so I do not think I would qualify for having that test as a never-smoker.