Medical surveillance of workers exposed to radon: new perspectives in lung cancer prevention

Radon is produced by the radioactive decay of Radium 226 (226Ra), in turn produced by radioactive decay of Uranium 238 (238U), found in ores such as lave, tables, granites and pozzolane. Lung cancer is still a disease with a high mortality rate responsible, worldwide, for about one in five deaths due to cancer. The health surveillance of workers exposed to Radon is aimed at the prevention and early diagnosis of lung cancer, which represents, in Italy, the second most frequent neoplasm in men (15%) and the third in women (12%). At present, however, screening strategies are proposed only in populations at high risk of developing the disease, as it is difficult to find a single very sensitive and highly specific biomarker. This situation implies that healthy subjects are subjected to Computed Tomography (CT) scan only after the onset of symptoms, leading to often late diagnosis, without a survival benefit. Currently the most promising biomarker is micro-RNA (miRNA, MSC), associated with Low Dose Computed Tomography (LDCT) scan. An optimization in the future of these tools and the cost-benefit ratio will open their use in early diagnosis, as well as their use also in the health surveillance of those exposed to Radon.