What should family members of individuals diagnosed with lung cancer know about lung cancer and screening?

From the Guidelines

Family members of individuals diagnosed with lung cancer should understand that early detection significantly improves survival rates and consider getting screened themselves, especially if they're between 50-80 years old with a significant smoking history (20+ pack-years) or if they're a current smoker or have quit within the past 15 years, using low-dose computed tomography (LDCT) as the recommended screening method. According to the most recent and highest quality study 1, LDCT screening has been shown to substantially reduce the risk of dying from lung cancer. The benefits of screening include a reduced risk of lung cancer mortality, while the limitations and harms include the potential for false-positive results, overdiagnosis, and unnecessary invasive testing.

Key Points for Family Members

• Be aware of common symptoms of lung cancer, including persistent cough, chest pain, shortness of breath, unexplained weight loss, and coughing up blood.
• Understand that genetic factors play a role in about 8% of lung cancer cases, so having a first-degree relative with lung cancer increases their risk.
• Avoid secondhand smoke exposure and consider radon testing in the home, as radon is the second leading cause of lung cancer.
• Familiarize themselves with treatment options like surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy to better support their loved one through their cancer journey.
• Current smokers should be informed of their continuing risk of lung cancer and referred to smoking-cessation programs, as screening should not be viewed as an alternative to smoking cessation 1.

Screening Recommendations

• The recommended screening method is low-dose computed tomography (LDCT), which can detect lung cancer at earlier stages when treatment is more effective.
• Screening is typically done annually for those at high risk, such as individuals with a significant smoking history or those who are current smokers or have quit within the past 15 years.
• The decision to undergo screening should be made after a process of informed and shared decision-making with a clinician, considering the potential benefits, limitations, and harms associated with screening for lung cancer with LDCT 1.

From the Research

Knowledge of Lung Cancer and Screening

• Family members of individuals diagnosed with lung cancer should be aware of the genetic and environmental interactions that predispose certain groups to lung cancer, including families 2.
• They should also understand the importance of communication between patients, families, and providers, as well as the challenges faced by caregivers and family members 2, 3.
• It is essential for family members to be informed about the risks and benefits of lung cancer screening, including the use of low-dose computed tomography (LDCT) for high-risk groups 4, 5.
• They should also be aware of the potential biases associated with screening, such as lead-time bias, length-time bias, and overdiagnosis bias 5.

Perception of Lung Cancer and Screening

• Family members may have mixed perceptions of lung cancer causation among relatives, and discussions about cancer risk with relatives can have complex dynamics 2.
• The diagnosis of lung cancer can have a significant impact on family health behaviors and screening, and family members may be interested in discussing risk factors, prevention, and diagnoses 2.
• Patients and family members may be unaware of LDCT screening for lung cancer but are receptive to the test, and concerns about screening include cost, radiation exposure, and transportation issues 6.
• Effective interventions for shared decision making to undergo lung cancer screening will require the active engagement of health care providers and the use of accessible decision aids designed for people with low health literacy 6.

Role of Family Members in Lung Cancer Screening

• Family members can play a crucial role in supporting patients with lung cancer and encouraging them to undergo screening 2, 3.
• They can also help facilitate communication between patients and providers, and provide emotional support during the diagnosis and treatment process 2, 3.
• Family members may need to be educated about the importance of lung cancer screening and the potential benefits and risks associated with it 4, 5.
• They can also help patients navigate the healthcare system and access resources and support services, such as genetic counseling and tobacco cessation counseling 2, 6.