A Silent Killer: The Overlooked Risk of Radon in Lung Cancer

Radon exposure is the leading environmental cause of non-smoking-related lung cancer cases; however, this risk factor is largely overlooked. While smoking cessation campaigns and screenings for high-risk individuals have gained traction, awareness of radon as a significant health hazard remains minimal, leaving many at risk without knowing it.

Radon highlighted on a periodic table of elements | Image Credit: ©angellodeco - stock.adobe.com

Lung cancer is the second most common cancer in both men and women in the United States, of which there were over 230,000 new diagnoses in 2024 alone. Smoking is the leading cause of lung cancer and cessation is considered the first method of prevention. However, there are cases of healthy, non-smoking individuals who are diagnosed. Most of these diagnoses can be attributed to exposure to radon, a radioactive gas that is highly associated with cancer risk. According to the United States Environmental Protection Agency (EPA), radon exposure is responsible for approximately 21,000 of lung cancer deaths every year, even for smokers.^1,2

Radon, referred to as a silent killer, comes from the natural decay of uranium in soil and rocks, which can enter buildings and homes through cracks or openings in the foundation. These airborne radioactive particles get trapped in the lungs and decay, resulting in small bursts of energy that damage tissues and thereby increase the risk of diseases such as emphysema, fibrosis, and cancer. Radon can also be found in drinking water from private wells, which is associated with increased risk of stomach cancer, kidney damage, and bone cancer.^3-5

Some populations are more sensitive to radon exposure than others, namely children—who are 2 times as sensitive as adults—individuals who smoke, and lung cancer survivors.⁵

"People who have smoked more than 100 cigarettes in their life are 10 times more sensitive to radon than non-smokers,” explained Phillip Gibson, MS, coordinator of the North Carolina Radon Program, North Carolina Department of Health and Human Services, in a virtual discussion hosted by LiveLung. “So, the damage began with tobacco smoke, which makes your lungs more vulnerable to this radioactive particle, thus increasing your risk.”⁵

Despite the proven associations between radon exposure and lung cancer, there is little in the way of policy to address this issue. Across the country, there are few regulations or standards around radon testing in public buildings or homes, meaning many individuals are unknowingly exposed.⁵

“We know that radon is a carcinogen,” said Terry Keys, research advocacy manager at the Markey Cancer Center at the University of Kentucky, in an interview with Pharmacy Times. “It's odorless, it's tasteless. You don't know that it's there. They know it's a problem, but there's no testing.”⁶

According to Gibson, some states do have policies to help mitigate and regulate radon. In North Carolina, there is no mandate that a home must be tested; however, if radon is found in a home, it must be disclosed to potential buyers. In Illinois, there are regulatory components around managing certified radon professionals and mitigation requirements. At the federal level, the EPA does provide funding to help support such programs.⁵

Patient advocacy is crucial to address the gap in recognition and screening for radon-induced lung cancer. The unfortunate reality is that non-smokers diagnosed with cancer are often overlooked, and consideration for risk factors outside of smoking is largely nonexistent. During his interview, Keys discussed a case of a healthy, physically fit, non-smoking patient who was diagnosed with stage 4 lung cancer. Tests revealed no genetic predisposition to the disease; however, radon levels in her basement bedroom were found to be 11 times higher than the safe limit.⁶

“If you smoked for years, yes, we're going to get you in and we're going to screen you. But they won't even think about [testing] top of mind if you're not a smoker,” explained Keys. “We live in a world full of radon, and we need to be thinking about how we can get more people access to that screening.”⁶

Recognizing radon exposure as a significant health risk highlights the importance of integrating environmental factors into discussions of lung cancer prevention and awareness. Expanding knowledge about this invisible threat underscores the value of early detection and targeted mitigation. As research and awareness grow, addressing radon exposure presents an opportunity to reduce preventable health risks and improve outcomes for patients.

REFERENCES

1. Key statistics for lung cancer. American Cancer Society. January 29, 2024. Accessed January 15, 2025. https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html

2. Health risk of radon. Environmental Protection Agency. December 2, 2024. Accessed January 15, 2025. https://www.epa.gov/radon/health-risk-radon

3. Health impacts from radon. NC Department of Health and Human Services. Accessed January 15, 2025. https://www.ncdhhs.gov/divisions/health-service-regulation/north-carolina-radon-program/health-impacts-radon

4. Riudavets M, Garcia de Herreros M, Besse B, et al. Radon and lung cancer: current trends and future perspectives. Cancers. June 27, 2022. doi:10.3390/cancers14133142

5. Gibson P. Reducing risks of radon-induced lung cancer. Presented at: Unmasking the Silent Threat: LiveLung Hosts Educational Virtual Meeting on Radon and Lung Cancer. January 8, 2025. Virtual.

6. Breaking barriers in cancer research: how advocacy and compassionate care enhance clinical trial access. Pharmacy Times. October 12, 2024. Accessed January 15, 2025. https://www.pharmacytimes.com/view/breaking-barriers-in-cancer-research-how-advocacy-and-compassionate-care-enhance-clinical-trial-access