After my mother’s lung cancer, should I get screened at 37?

Question

Hello doctor,

I am 37, and I have been smoking since I was 16. My mother passed away last year from lung cancer. She smoked for nearly 30 years, and by the time they caught it, it was already stage 3B with mediastinal involvement. Her CA 19-9 U/mL and CEA were both very elevated, and she deteriorated so quickly after diagnosis.

Since she died, I cannot stop thinking that I am going to end up the same way. I keep waking up at night, checking if I have a cough or chest pain. I tried quitting twice but went back after a few weeks. My chest X-ray last month was clear, and my doctor said I was fine, but I cannot shake the fear.

Is the risk of lung cancer significantly higher for me, given my family history and my own 21-year smoking history?
Should I be doing low-dose CT screening already at my age?
And what actually works for quitting when you have tried and failed before?
Is Varenicline still considered safe?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I am really sorry about your mother. Losing someone like that, especially after seeing how quickly things progressed, stays with you for a long time. Many people in your situation start noticing every small sensation in the chest, and it becomes difficult to switch off those thoughts, especially at night.

Coming to your question, yes, smoking for over 20 years does increase your risk of lung cancer compared to a non-smoker. Family history like yours adds a small additional risk, but smoking remains the main factor. The important thing in your case is that your recent chest X-ray is clear, which is reassuring at present.

At your age of 37, routine low-dose CT screening is usually not advised unless there are very strong additional risk factors. Most recommendations begin screening later, typically around 50 years of age, with a heavy smoking history. Doing CT (computed tomography) scans too early can sometimes lead to unnecessary worry because of small incidental findings, which are often harmless.

What will make the biggest difference for you is quitting smoking now. I have seen many patients who had similar fears after a family loss, and those who stopped smoking in their 30s significantly reduced their future risk. Even after years of smoking, the body starts recovering once you quit.

Regarding quitting, going back to smoking after a few weeks is very common and does not mean you cannot quit. Nicotine dependence is strong, and most people need multiple attempts.

Medicines do help. Varenicline (Varenicline tartrate) is still considered safe and is one of the most effective options we use. It reduces both craving and the satisfaction from smoking. Some people may get mild side effects like nausea or vivid dreams, but overall, it is well-tolerated. Using it along with a fixed quit plan improves success.

The fear you are having waking up and checking for symptoms is something I see quite often after a loss like yours. It is more related to anxiety than to the actual disease, especially when your investigations are normal. Addressing this part is equally important; it keeps feeding the urge to check and worry.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.