Asbestosis & Cancer Detection
Pulmonary asbestosis and asbestos-related pleural disease are
often not recognized on chest x-rays and CT-scans reviewed by
radiologists and pulmonologists. Specially trained doctors who
are certified by the National Institute of Safety and Health
(NIOSH) (who are called "B" readers) may sometimes
detect asbestos-induced x-ray changes that other doctors miss.
It is generally recommended that anyone who has been occupationally
exposed to asbestos have a chest x-ray taken every 18 to 24 months
and reviewed by a certified "B" reader or someone experienced
in diagnosing asbestos-related diseases.
In the past, the standard way to diagnose asbestos-related pleural
and pulmonary disease and cancers was through x-rays. Over time
it has become clear that the use of an x-ray, while an excellent
diagnostic technique, has short-comings. The major short-coming
is that it fails to detect with significant clarity, early signs
of cancer and/or pleural and pulmonary disease. In this regard,
recent advances in science have developed two new procedures
that can detect asbestos disease at an earlier stage.
These new procedures, low-dose spiral computed tomography and
high resolution computed tomography (HRCT), are based upon computer
tomography (CT).
When screening for early detection of various forms of cancer,
low dose spiral computed tomography is exceptional in detecting
early peripheral lung cancer. In various studies, it has been
shown to be far superior to normal x-rays and CT scans of the
entire lung. If the spiral CT shows indications of early nodules,
then HRCT should be used.
HRCT has been shown to be extremely sensitive in diagnosing
pleural and pulmonary asbestos-related disease. In one particular
study, x-rays indicated that 33% of subjects had asbestos-related
pleural disease. When those same individuals were examined with
HRCT, 66.5% showed pleural thickening. In the same study, x-rays
found pulmonary asbestosis in 5.3% of the individuals tested
while HRCT found that 20.6% of those individuals had pulmonary
asbestosis. As is clear from this study and many others, the
sensitivity to HRCT in detecting pleural and pulmonary disease
is far superior to that of standard x-rays. HRCT is also superior
to x-rays in regard to early diagnosis of cancer.
In light of the above, individuals at risk for asbestos-related
disease today are far better off than individuals even a few
years ago. Because of low-dose spiral computed tomography and
HRCT, individuals can now be subjected to a painless examination
to provide early detection of cancer and/or pleural or pulmonary
disease. By providing early detection of cancer, the cure rate
should rise substantially in the future.
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