Being a lifelong health enthusiast, health educator and fitness trainer — and married to a primary care physician — my family and I were blindsided by my Stage 3A lung cancer diagnosis in October of 2018. We were shocked as I had no respiratory symptoms and I have never smoked. My cancer was found incidentally while investigating what later turned out to be a benign ovarian cyst.
It wasn’t until my son, an environmental engineer, asked me if I had ever tested our home for radon when I learned that virtually anyone with lungs can get lung cancer and that radon is the second leading cause of lung cancer in the United States. It is the first leading cause of lung cancer in people who don’t have a history of smoking.
Considering the risk for lung cancer is high, why aren’t people exposed to high radon levels eligible for lung cancer screening? The United States Preventive Services Task Force recommends people ages 50-80 with a 20-pack year history of smoking, or have quit in the past 15 years, get a low dose CT scan, which is painless and takes only a few minutes.
Based on the conversation with our son, we tested our home using methods recommended by the Environmental Protection Agency and discovered that the radon levels in our home were elevated above the threshold of 4 pico curies (pCi/L). The EPA strongly advises that any radon level at or above 4 pCi/L should be reduced through a radon mitigation system. Radon mitigation needs to be done by professionally accredited operators and most health departments — including the Colorado Department of Public Health and Environment — post lists of accredited mitigators.
Radon is an invisible and odorless radioactive gas that can be found in many homes. It comes from the decomposition of uranium in soil, rock and water and gets into the air you breathe. When inhaled, radon can cause serious health problems including lung cancer. About half of all homes in Colorado have radon levels above the recommended limit of 4 pCi/L.
While there is no way for me to know with certainty if radon caused my lung cancer, I want people to know it is one risk factor that can be tested for and reduced to safe levels very easily. I also want people to know that smoking and exposure to radon are not the only risk factors for lung cancer and that many people develop lung cancer despite having no known risk factors. Exposure to secondhand smoke, family history of lung cancer and air pollution are risk factors for lung cancer. Report any persistent symptoms you have to your doctor. Being young and having no known history of tobacco use does not make you immune to lung cancer, even if the risk is low.
Despite the well-known risks of radon, it concerns me that there isn’t more public health messaging about radon, especially given its high prevalence in Colorado and many other states. The EPA estimates that radon kills approximately 21,000 people in the U.S. every year and about 2,900 of these deaths occur among people who have never smoked. These numbers may be a low estimate, as I know my doctor never asked me if I knew the radon level of my home when I was diagnosed. In fact, only a small number of family physicians transmit radon information to their patients. Please consider testing your home for radon at least every two years as recommended by the EPA because levels can change due to movement of soil, or new cracks in the foundation. Even if you have a mitigation system, testing is still recommended. A mitigation system is like any other appliance, and it can malfunction or stop working.
Learn more about radon and radon mitigation from the EPA and the Colorado Department of Public Health and Environment.
Heidi Nafman Onda is a cancer survivor and health educator