As a recent medical journal article said, “Counseling around unhealthy or risky behaviors is an important communication skill that should be part of health care visits.” That is why radon professionals believe that doctors should be talking to their patients about the dangers of radon exposure. Yet we know that physician-patient discussions about radon are not routine. In fact, they are rare. In this blog, I want to explore this apparent contradiction, which looks like a case of cognitive dissonance. In later blogs, we will try to explain the reasons for this situation, and also look at what doctors could or should be telling patients about radon. Perhaps most importantly, I hope we can discuss how to work effectively with the medical community and what physicians should be saying about radon.
To set the stage, let’s start with six or seven simple facts.
As a society, we need to do everything we can to prevent lung cancer. Lung cancer is a devastating disease. It takes a tremendous personal and societal toll. By the time most lung cancer cases are diagnosed, the prognosis is not promising. Only 16 percent of lung cancers are detected before the disease has spread to other parts of the body. And the cost of treating lung cancer is exorbitant. In 2004, the CDC estimated that lung cancer treatment cost $9.6 billion nationally.
The best way to prevent most lung cancer is to get people to stop smoking. Smoking accounts for the majority of lung cancer cases. But stopping smoking alone is not enough to reach our societal goal. We also need to prevent radon-related lung cancers, because radon is the leading cause of lung cancer among non-smokers and people who both smoke and are exposed to high levels of radon are at greatly increased risk.
The medical community has been very active in advocating against smoking. Doctors regularly counsel patients to quit smoking, and warn of the hazards of exposing children to exhaled cigarette smoke. They are aggressive anti-smoking advocates. They are also effective communicators. After all, they are in positions of authority, seen as health experts and widely respected -- they wear the white hats and the white coats.
It would seem logical then, to enlist physicians as anti-radon advocates, too. Wouldn’t we want them to talk to their patients about radon’s health hazards, counsel patients to test for radon, and advise patients to fix radon problems in their homes? Isn’t this just a part of the lung cancer prevention strategy that would have so much societal benefit? It would seem to be an easy sell to get the medical community to make this small, yet significant expansion in their lung prevention counseling and communication.
Unfortunately, it’s not that easy. There are several stumbling blocks. In my next blog, I will identify and discuss the things that might be holding physicians back.
Dr. Paul Locke is a radon leader who has over 20 years of experience in radon science, policy and law. Dr. Locke is an Associate Professor at Johns Hopkins Bloomberg School of Public Health.
United States