Screening advised for families with lung diseases

New research suggests that genetics may make people susceptible to lung cancer, chronic obstructive pulmonary disease (COPD) and reduced lung function. If so, then a family history of these disorders should place individuals in the high-risk category.

If they also have a history of smoking, then they should be screened with a CT scan, investigators suggest in the American Journal of Respiratory and Critical Care Medicine.

“Because cigarette smoking is such an overwhelming risk factor and preventable, the importance of family history and genetic susceptibility to lung cancer risk has been overlooked,” Dr. Ann G. Schwartz said in a press statement.

Schwartz and Dr. John C. Ruckdeschel, both from Wayne State University in Detroit, looked into published medical studies assessing the role of familial risk in lung cancer.

They note that in one study, 14 percent of more than 26,000 patients with lung cancer had at least one first-degree relative with the same disease, and 52 families had at least three relatives with lung cancer.

The average age of onset was 60 years for those with a family history, compared with 70 years in the general population.

The team also found studies suggesting that lung function, COPD, and lung cancer were linked to regions on chromosomes 6 and 12. Several genes in these regions could make someone susceptible to lung diseases.

“We are of the opinion that studies of spiral computed tomography (CT) screening and lung function testing are warranted in current or former smokers with a strong family history of lung cancer, particularly when age at diagnosis of the family member is young,” Schwartz and Ruckdeschel conclude.

The researchers also recommend that doctors ask patients with COPD about any family history of lung cancer, and vice versa, as well as age of disease onset, so that “referral into screening programs and prevention trials can be better targeted to reach families with both a history of lung cancer and COPD.”

SOURCE: American Journal of Respiratory and Critical Care Medicine, January 2006.

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