Smoking and tobacco use remains the leading cause of preventable death in the United States, with few groups as heavily impacted as active-duty service members and veterans. A recent CDC study found that more than 1 in 5 (21.6%) veterans in the United States reported currently using cigarettes. Tobacco use and job-related exposure to potentially hazardous conditions make the possibility of developing lung disease likely for many veterans. Dr. Joel Nations, a veteran himself, has spent the last 20 years committed to treating the ailments of those who served in the Navy, Army, Air Force and Marines. He has seen first-hand the impact tobacco use has had on this community and how lung cancer screening could save the lives of many of his fellow service members and veterans.
“Historically, veterans have a higher rate of smoking. This is especially true for military members during deployment,” Dr. Nations explained. “Similarly, when people leave the military, they are more likely to continue smoking, which is why veterans are at high risk for lung cancer.”
What May Make Veterans High-Risk
The current lung cancer screening guidelines do not include other risk factors besides tobacco use. But there are many potential risk factors that may cause lung cancer to develop. These can include radon and secondhand smoke, which are well documented, as well as poor air quality. However, for veterans, this may also include occupational hazards that they may have been exposed to during their service. That is why you should always let your doctor know if you served in the military.
“The only preventive tool we have for lung cancer is never to start smoking, and if you do smoke, consider cessation programs to help you quit,” said Dr. Nations.
Understanding Lung Cancer Screening for Veterans
Since studies have found that many veterans are at higher risk for developing lung cancer, it stands to reason that they would be more vigilant than most about lung cancer screening. But even though an early diagnosis can mean the difference between life and death, many people do not utilize this vital tool. “Sometimes patients don’t get screened because they are anxious about the test results. But for those who are eligible, it is the best way to catch lung cancer early, which we know leads to better survival rates,” Dr. Nations said.
As any pulmonologist will explain, the test is simple and pain-free, and once enrolled, your healthcare team will remind you annually to get scanned. “I have conversations with my patients weekly encouraging them to get screened if they smoked in the past or, if they are current smokers, to get scanned and join a smoking cessation program,” Dr. Nations explained. “Someone who had smoked in the past may not think to ask about lung cancer screening. But even if you stopped smoking 10 or 15 years ago, you may still be at high risk.”
A few years ago, lung cancer screening eligibility criteria changed to include even more people who may be at high risk for lung cancer. Under these new guidelines, people 50-80 years of age with a 20 or higher pack-year history (people who smoked 1 pack/day for 20 years, 2 packs/day for 10 years etc.) who currently smoke or have quit within the last 15 years are eligible for a low-dose CT scan annually. So, an estimated 14 million people in the US, many of them veterans, are at high risk for lung cancer and should be screened annually. Unfortunately, according to the Lung Association’s State of Lung Cancer report, only 16% of those eligible were screened in 2023. This needs to change as early detection with low-dose CT screening can decrease lung cancer mortality by at least 20 percent among high-risk populations.
“The goal of screening is to diagnose lung cancer early when it is much more treatable. This is why the VA has made a focused effort to promote low-dose CT scans,” Dr. Nations explained. Veterans who receive care from the VA may be alerted to their eligibility, but for those who use some other form of healthcare, you might need to take things into your own hands. Talk to your healthcare provider about whether you qualify for screening, and they will guide you.
Blog last updated: November 11, 2024
