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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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According to the American Cancer Society, approximately 14,100 new cases of invasive cervical cancer will be diagnosed, and 4,280 women will die from cervical cancer. However, cervical cancer is preventable with regular screening tests and the HPV vaccine. It’s important to note that medical advances have allowed progress in diagnosing and treating cervical cancer. While it used to be one of the most common causes of cancer death for American women, the incidence of death has significantly declined. What to Know About the HPV Vaccine HPV vaccination is the best way to prevent cervical cancer and is recommended for all youth starting as early as age 9, or for teens and adults up to age 45 who didn’t start or finish the series. In Nevada, only 50.1% of teens ages 13-17 have been vaccinated for HPV.  There are 13 types of HPV, and the vaccine Gardasil 9 protects against 9 of those HPV strains, greatly reducing the incidence of cervical cancer among vaccinated individuals. What to Know About Cervical Cancer Screenings The CDC says the most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21. And there are two common tests that can detect early stages of cervical cancer (or precancer) and improve health outcomes. The pap test (or pap smear). This screening looks for precancers. Women should begin getting pap smears when they’re 21. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. Cervical Cancer Screening Schedule The American Cancer Society offers the following guidelines for screenings: All women should begin cervical cancer screening at 21. Women between 21 and 29 should have a pap test every three years. Beginning at 30, the preferred way to screen is with a pap test combined with an HPV test every five years. This is called co-testing and should continue until age 65. A pap test (or pap smear) is performed during a regular screening appointment to look for precancers, cell changes on the cervix that might become cervical cancer if they are not evaluated or appropriately treated. Typically outpatient procedures can reduce the risk of long-term health impacts that prevent pre-cancerous cells from becoming cancer cells. Women over 65 who have had regular screenings in the previous ten years should stop cervical cancer screening as long as they haven’t had any severe precancers found in the last 20 years. How to Get Screened Request an appointment with your primary care physician or OBGYN to schedule a screening.

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March is Colorectal Cancer Awareness Month, and we want you to receive the best preventative care possible. Early detection can help prevent serious illness, yet many people still choose to skip their annual exams and routine screenings. Bonnie Ferrara, MD, MPH, Section Chief for Primary Care at Renown Medical Group, further explains the importance of this simple, easy way to stay healthy. Why are annual exams so important? The benefits of early detection and prevention to save lives and reduce the impacts of disease have been proven. These exams are the perfect opportunity to get your health questions answered. “This is your chance to sit down with your provider and talk about your overall health and your family’s health history as well as your concerns for the future,” says Bonnie Ferrara, M.D., family medicine. “It’s the opportunity for your provider to talk with you about your lifestyle, tobacco use, exercise and alcohol use, all of which make a difference in your future longevity.” The annual wellness exam is also an ideal time for most adult patients to discuss health screenings. In addition, these visits are the perfect time to address issues that may not directly relate to a particular medical problem or immediate illness. A good rule of thumb is to schedule these appointments around your birthday each year to make sure you and your provider are both updated on your care. Why would you need an annual exam if you aren’t feeling sick? According to Dr. Ferrara, seeing your care provider when you aren’t sick is one of the best times. “It is better if you try to arrange this visit when you are not feeling ill,” she says. “It is an opportunity to talk about wellness. Not only how to contribute to your wellness but also the changes that you can make that will make huge dividends in the future for your wellness. In addition, it allows us to do some education about what to expect in the coming years as far as your health and lifestyle changes.” What can you expect at an annual exam? Annual exams usually check your: History – lifestyle behaviors, health concerns, vaccination status, family medical history Vitals – blood pressure, heart rate, respiration rate and temperature General appearance – your care provider can find out a lot about you just by watching and talking to you Dr. Ferrara adds, “If this is a Medicare annual wellness exam, it is an opportunity to talk to your provider about depression and dementia as well as be tested for those.” You can also leverage your annual exam to speak to your provider about managing your chronic health problems. "As a provider, these visits give us the opportunity to hear how the medications and lifestyle changes we have recommended are working and if you are having problems with these, we have the opportunity to make suggestions of how to do things better for the future," Dr. Ferrara.

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Winter skin alert – cold temperatures can put your skin into chaos. We asked for skin tips from Heidi Nicol, an esthetician with Renown Dermatology, Laser & Skin Care. She shares how to keep your skin glowing through the frosty months ahead. With the change from warm to cold weather, your skin can get stressed out. In fact, issues like flaky skin, irritation and chapped lips can be an everyday struggle. 5 Easy Winter Skincare Tips 1. Re-think your shower Few things feel better on a cold day than a long, hot shower. But hot showers can lead to dry skin because they strip your skin of its natural protective oils. Avoiding them altogether is best – choose a lukewarm, or warm, shower instead. If you have an occasional hot shower, the American Academy of Dermatology (AAD) suggests keeping it at five to ten minutes. Nicol recommends using a gentle cleanser and avoid using too much. Moisturizing after a shower or bath while your skin is still damp is also a must. Slathering on your favorite lotion helps your skin hold on to precious moisture. 2. Stay away from smoke and fire Although sitting close to a roaring fireplace can feel good, it is drying to your skin. Smoking and exposure to smoke also harms your skin. Smoking reduces healthy blood flow to the skin. This also causes your skin to wrinkle faster, making you looker older. Additionally your skin heals much slower if you smoke. 3. Consider a humidifier Cranking up the thermostat dries out indoor air. Skin is our largest organ, and in general, heat is very drying to your skin. To clarify, over time dry air degrades your skin’s natural moisture (lipid) barrier leading to flaking, peeling and cracking. Your skin can overcompensate for the dryness by producing even more oil. In other words it is possible for your skin to be both oily and dehydrated at the same time. Even oily skin needs a daily lightweight, non-pore clogging moisturizer. 4. Use SPF daily The sun’s rays damage your skin even on cloudy days. Sunlight contains UVB (burning) and UVA (aging) rays. Although UVB rays are less strong in the winter, the UVA rays are same strength all year. And snow can reflect almost 90% of UV radiation. With this in mind make sure you have suitable skin and eye protection when going outdoors. 5. Take care of your hands and feet Don’t forget your fingers and toes when moisturizing. These areas tend to be drier than other parts of the body. Gloves help to protect hands from winter weather and lock in moisture. Similarly, putting lotion on your feet before your socks will keep them your skin from flaking and cracking. Follow the tips above to make sure your skin is at its best, despite the winter weather. Renown Dermatology, Laser & Skin Care | 775-982-8255 Renown Dermatology, Laser & Skin Care offers a comprehensive range of treatments and products to address any skin care need. Visit our beautiful office in south Reno and browse our product lines. Experts are available to answer any questions concerning your skin care and health and wellness needs.

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Did you know that your makeup brushes are likely full of built-up dirt and bacteria? Using dirty makeup tools can lead to irritation, breakouts and even infections. The good news? It's completely preventable. An expert explains For anyone who regularly wears makeup, brushes are great tools for powdering, contouring and finishing touches. Unfortunately, these same brushes also harbor harmful bacteria that can clog pores and cause unwanted breakouts. “Brush hairs and sponges are porous, and hold on to oils, debris and bacteria,” says Heidi Nicole, medical esthetician with Renown Dermatology, Laser & Skin Care. “Also, if they are dirty, the application of makeup can be spotty and make blending more difficult." Most dermatologists suggest that you clean your makeup brushes at least once a week. Because they are used on your face, it makes sense to keep them as a clean as possible. In addition, your brushes will last longer if you stay on top of cleaning them. Six simple steps to integrate makeup brush care into your beauty routine: Wet your brush with lukewarm water. (Don’t soak your brushes, as water in the brush barrel can cause the hairs to fall out.) Place a drop of gentle cleanser or specialized brush cleaner in the palm of your hand. Gently massage the tips of the bristles on your palm. Rinse the bristles well. Blot with a clean towel and reshape the head. Let the bristles dry over the edge of a counter. Do not allow the bristles to dry on the towel, which could cause the brush to mildew. Store your brushes in a clean, dry place in between uses.

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You might think worsening eyesight is inevitable as you age. But the truth is, there are easy things you can do to keep your eyes in tiptop shape for years to come. Clear vision is an essential part of overall health and there are daily habits we can adopt to keep our eyes seeing clearly. Mitchell Strominger, M.D., a registered ophthalmologist with Renown Health specializing in pediatric ophthalmology and neuro-ophthalmology, offers some everyday tips to keep you focused on eye health. Know your family’s vision history Look to your parents and grandparents for clues about the future of your eye health. Were they near-sighted at a young age? Do they have a history of eye crossing or a lazy eye? Did they develop glaucoma or macular degeneration (AMD)? Some genes have a strong association with eye health, specifically macular degeneration. AMD is a leading cause of blindness worldwide and the top cause of vision loss and blindness for Americans over 65, according to the Centers for Disease Control and Prevention (CDC). Also be aware certain medical conditions, such as diabetes, high blood pressure and liver disease, increase the risk of long-term eye problems. Receive regular vision screening exams Children under three need vision screening examinations by their pediatrician. A medical concern or family history warrants a comprehensive eye examination by a pediatric ophthalmologist (or general ophthalmologist or optometrist who has experience with children) per the American Academy of Ophthalmology (AAO). Vision screenings should occur every two years throughout adolescence unless pain, eye crossing, difficulty seeing the board or reading, or other eye concerns occur. In adulthood the risk of eye problems increases over age 40, so the AAO recommends regular dilated exams. When your pupils are dilated it allows your eye care professional a more accurate view of your retina and optic nerve, located in the back of your eye. This allows them to look for AMD or other eye problems. Eye diseases can be caught at their earliest stages during a dilated eye exam. “It is especially important to have your child evaluated as soon as possible if there is any concern for eye crossing or lazy eye,” says Dr. Strominger. “The visual system develops in the early years so intervention, whether it be glasses, eye patching to strengthen the vision in one eye, or eye muscle surgery is critical. Children at risk include those who are born premature, have development abnormalities, genetic disorders such as Downs syndrome, or a strong family history and should be evaluated at a young age. Often small problems are not clearly evident and cannot be picked up on routine screening examinations in the pediatrician’s office.” Block the sun, improve your vision Everyone knows not to stare directly into the sun, but indirect ultraviolet (UV) sun rays can cause serious harm over time. According to the National Eye Institute, sunglasses (or a protective UV tint) are a daily must to protect your eyes from: Cataracts (a clouding of the eye’s lens causing blurred vision) AMD - macular degeneration Pterygium (a tissue growth over the white surface of the eye that can cause astigmatism) Look for sunglasses which block 99 to 100 percent of both UVA and UVB rays. You still need sunglasses if your contact lenses block UV rays. Sun rays can damage your eyelids and other tissue not covered by contact lenses. Wearing sunglasses protects your entire eye area. Eat colorful meals Your eyes need vital nutrients to keep them healthy including vitamin C, zinc, beta carotene and copper. A diet filled with citrus fruits and a variety of vegetables provide these essential nutrients. Regularly filling up on fish high in omega-3 fatty acids (salmon, tuna, sardines) may reduce your risk of AMD and help maintain your eye health. Green, leafy vegetables (kale, spinach, collard greens) containing lutein and zeaxanthin are also a must for your dinner plate. Water your eyes Eyes, like the rest of your body, need plenty of water to prevent dehydration. Make sure you stay hydrated and steer clear of smoke to avoid dry eyes and irritation. Hours staring at the computer screen can also make your eyes feel dry or tired. Try regularly refreshing them with lubricating eye drops. Taking frequent computer breaks is also important. Follow the 20/20/20 rule: every 20 minutes, look at an object 20 feet away from you for 20 seconds. Eye makeup can also lead to dry eye as the glands at the base of the eyelashes may become clogged, causing dry eye. Make sure all eye makeup is hypoallergenic and is thoroughly removed with a gentle cleanser for the delicate eye area each day. Stop Smoking (or never start) Smoking is harmful to every part of your body, including your eyes. It's not only linked to cancer and heart disease but also cataracts, AMD, dry eye, optic nerve problems and many other problems. Smoking during pregnancy can also harm the eyes of the unborn child. If you currently smoke take steps to quit and your entire body will benefit.

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As we begin to enjoy the springtime weather in northern Nevada, are you finding your skin less than tip-top shape? Here’s how to add moisture back in easy, natural ways. You don’t need to be a medical aesthetician: Dry, cold climates can often wreak havoc on your body’s largest organ — your skin. These tips from Renown Dermatology, Laser & Skin Care will quickly put moisture back and relieve dry, chapped skin. 11 Miraculous Moisturizing Tips Always wear broad-spectrum sunscreen, even during winter months. Don’t forget to use an SPF lip balm, too. Heaters dry out your skin. Use a humidifier to keep moisture in the air. (And try these simple tips to make sure you’re keeping that humidifier clean.) If your skin is dehydrated, try using a nighttime moisturizer during the day. Use a hydrating mask or moisturizing mask twice a week. Don’t forget your hands and feet. Apply a rich cream to the hands and feet at night and cover them with gloves and socks to restore moisture while you sleep. Drink plenty of water to stay hydrated. Try adding a hydrating serum to your morning and nighttime skincare routine to heal the skin. Use a gentle exfoliant to remove dry skin at least once a week, which helps your skin absorb your moisturizer. Apply body oil or lotion in the shower while your skin is still damp to trap moisture. Hot water dries out your skin, so turn down the temperature in the shower and bath.   A little pampering goes a long way, and Renown’s medical aestheticians are here to help. Trained in skincare and advanced therapies, our experts can transition your skin to look healthy, youthful and rejuvenated.

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Unfortunately, men are less likely to visit their doctor for exams, screenings, and consults than women. So with the help of Bonnie Ferrara, MD of Renown Health, we've put together a list of eight screenings to help men stay on top of their health game. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.

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You want to protect yourself and your family from the harmful rays of the sun — which are especially punishing at northern Nevada’s higher altitudes — but with so many options, how do you choose the right sunscreen? We asked our expert, Dr. Angela Walker, a dermatologist with Renown Medical Group, to shed some light on the subject. Sunscreen Application Dermatologists recommend a broad-spectrum sunscreen with a minimum SPF of 30, but keep in mind that no sunscreen protects against 100 percent of UV radiation and that reapplication is necessary. “No matter the SPF, sunscreen must be applied adequately and frequently, meaning a quarter-sized amount to cover the face and neck and a full shot glass amount for the body when wearing a bathing suit,” said Walker. “Reapplication should be every 80 minutes.” Why not use a high SPF, such as 70 or 100? According to the Skin Cancer Foundation, they don’t offer significantly more protection than SPF 30 and mislead people into thinking they have a higher level of protection. Here’s the breakdown: SPF 15 blocks 93 percent of UVB rays SPF 30 blocks 97 percent of UVB rays SPF 50 blocks 98 percent of UVB rays SPF 100 blocks 99 percent of UVB rays Do specific populations require a higher SPF? Walker explains that infants, seniors, and those with a history of skin cancer must take precautions against UV radiation, as their skin is vulnerable. Sunscreen should be an absolute priority before spending time outdoors and avoiding prolonged sun exposure, wearing a hat with wide brim (recommended 4-inch brim) and UPF (ultraviolet protection factor) clothing. Due to the sensitive nature of an infant’s skin, babies under six months should not spend time in the direct sun. For infants and toddlers six months and older, whose skin is thinner than adults, a sunscreen that contains zinc oxide or titanium dioxide (physical protectors) should be applied. Zinc and titanium are less likely to irritate because they do not penetrate the skin and instead sit on the surface and deflect UV radiation. Zinc oxide and titanium dioxide are vital ingredients to seek out in sunscreen due to their strong ability to deflect UV radiation. Sunscreen Terms Explained UVA = Long wave ultraviolet light. Penetrates deep into the dermis, the skin’s thickest layer, causing tissue damage that wrinkles and photo-aging and contributes to developing skin cancer. UVB = Short wave ultraviolet light. The biggest contributor to the development of skin cancer and are more prevalent during mid-day. SPF = Sun protection factor. Calculated by comparing the amount of time needed to burn sunscreen-protected skin vs. unprotected skin. So, SPF 15 means you can stay in the sun 15 times longer than you could without protection.

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Since the COVID-19 pandemic, more people are working from home than ever before, leading to a rise in digital screen time. Between spending eight or more hours staring at a computer screen, and some downtime hours spent looking at a smartphone or watching TV, it’s almost inevitable to feel some adverse effects at the end of a day. Blue Light Effects vs. Digital Eye Strain Blue light is all around us, and the most natural source comes primarily from sunlight. Other forms of blue light are artificial and emitted by digital screens including LED TVs, smartphones, tablets and computers. Surprisingly enough, research shows blue light can actually have health benefits such as promoting alertness, boosting memory and cognitive function, elevating mood and regulating circadian rhythm. However, studies indicate that an excess in blue light exposure can lead to depletion of melatonin production, a hormone that regulates our sleep cycles. In today’s eyewear industry, blue light glasses are one of the more popular items purchased by consumers. Companies who sell the glasses claim they help with reducing or eliminating digital eye strain, while also increasing natural melatonin secretion to get a good night’s sleep. Other than their slight yellow tint to filter out blue light, they mostly look like regular glasses and come in many different stylish frames. You can find blue light glasses through various eyewear retailers. Most adults have experienced digital eye strain. Common symptoms of digital eye strain include headaches, blurred vision, irritated eyes, and fatigue. Many believe that digital eye strain is caused by overexposure to blue light, but medical vision experts say that is not the case. “Digital eye strain is related to how we use our digital devices, not the blue light coming out of them,” says Mitchell Strominger, MD, a neuro and pediatric ophthalmologist with Renown Health. Do Blue Light Glasses Even Work? Since blue light glasses aren’t medically proven to help with digital eye strain, you’re probably wondering if they’re even worth using. “If you’re one to binge a TV show or scroll though social media before bedtime, the blue light from those digital screens can disrupt your circadian rhythm and cause you to lose sleep, which can ultimately lead to other adverse health effects,” says Dr. Strominger. “While more research is still needed, some studies have shown that blue light glasses may prevent melatonin suppression and increase quality of sleep. There is no harm in trying them out and seeing if they work for you.” As for preventing digital eye strain, Dr. Strominger shared several helpful tips: Try using the 20-20-20 rule, which entails looking away from your screen and looking at an object 20 feet away for at least 20 seconds. Sit at an arm’s length (about 25 inches) away from your screen. Adjust the brightness and contrast of your screen, especially before bedtime. There is a night mode setting on most smart phones you can use. Reduce your screen time whenever you can and give your eyes a break.

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Want to protect yourself from skin damage from the sun’s harmful rays? Dr. Angela Walker, dermatologist with Renown Medical Group, shares what you can do to prevent skin cancer. What can people do to prevent skin cancer while enjoying the outdoors? There are several steps you can take to protect your skin from the sun. “I caution all of my patients to avoid the sun during the hours of 10 a.m. until 2 p.m. when UV rays are strongest. I also encourage people to wear sleeves on cooler days. And don’t forget that we still need to wear sunscreen on cloudy days! UV rays can still cause sun damage on cloudy days. Preventing skin cancer also entails wearing sunscreen of at least SPF 30 everyday.  Are hats also a good idea for skin protection? Yes, of course! Choose a wide-brim hat that shades the face as well as the back of the neck for extra protection against UV rays. When it comes to identifying skin cancer, what should people watch for? We use easy-to-remember letters when checking for spots on the skin; it’s called the ABCDEs: How often should people go to a dermatologist for a full-body skin check? People with a family history of melanoma or who have already had skin cancer need to be screened at least once a year. Those who are younger and use sunscreen daily don’t need to be seen as regularly. Their primary care provider can do a yearly screening. And remember to do self-screening at home to keep an eye out for unusual looking spots. Is it best to visit a care provider with an expertise in skin with questions or concerns? Absolutely. As a dermatologist, I see a lot of people coming in with a changing mole or brown spot that looks irregular. I can assure them it’s benign or get them the treatment they need. We can even use photography to monitor skin spots and have the patient take photos at home. We also perform biopsies as needed.

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Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution.  What are the risk factors of lung cancer?  Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk.  People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening.  People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.

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