Screening only recommended for those at high risk

Dear Dr. Roach: For over six decades, I have lived with smokers. My parents smoked inside our home and the car. Later, most of my siblings smoked. Family gatherings were always smoky affairs. I also married a smoker who smoked in the house until an infant grandson came to live with us. My husband continued to smoke in the car. A collapsed lung during a biopsy led him to quit last year. He has COPD and is on oxygen.

Three uncles died of lung cancer. All were heavy smokers who also worked in mines. My grandmother, also a smoker, died of complications due to emphysema. With all that communicated to my physician, I am curious why he has never suggested a lung scan as a precaution. — L.H.

Dear L.H.: Lung cancer remains the single leading cause of cancer deaths. Early on, there are no signs nor symptoms, but coughing, shortness of breath and chest discomfort are among the first signs. Smoking is by far the biggest risk factor for developing lung cancer. It is true that secondhand smoke increases the risk.

No studies have examined lung cancer screening in nonsmokers. While it may seem there is no downside, there are at least two. The first is the time, expense and radiation dose of the scan. The second is that the scan can sometimes detect abnormalities that require further evaluation.

Lung cancer screening is recommended for people at higher risk for lung cancer: those who have smoked the equivalent of a pack a day for 15 years.

Quitting smoking is the best way to reduce your own risk of lung cancer.