Check family history for lung cancer risk

GPs have been urged to stay alert for lung cancer symptoms in patients with a strong family history of the disease because they are at high risk of developing the condition.

The recommendation follows suggestions by US researchers that current or former smokers with a family history of lung cancer should be screened for early signs because they have a two- to three-fold increased risk of developing the disease.

The researchers, from the Karmanos Cancer Institute in Detroit, cited studies that suggested that as many as 14 per cent of patients with lung cancer have first-degree relatives with the disease.

They also state that the median age of onset of lung cancer for patients where the disease is already in the family is about 50, compared to 70 for the general population.

The researchers suggested that high-risk patients could be identified by opportunistically collecting family history in patients with COPD who were likely to have a history of smoking. They also recommended that patients with a family history should undergo a lung function test and screening with a spiral CT scan.

'The ability to focus efforts in a high-risk population would be of benefit now,' they said.

Somerset GP Dr Steve Holmes, chairman of the General Practice Airways Group (GPIAG), said he was not sure whether CT scan screening would be practicable under the NHS. But he added that although patients with a strong family history were rare in general practice, it was worth paying particular attention to symptoms that might indicate lung cancer.

'In the UK we are well below the average European lung cancer survival rates,' he said.

'Anything that can help to diagnose lung cancer earlier is a bonus because we would like to be able to pick it up earlier.'

Am J Respir Crit Care Med, 2006; 173: 16-22

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