A Navy birthday tribute: Rethinking lung cancer screening for asbestos-exposed veterans
Much like other coastal port localities in Maryland, Baltimore has long understood what it truly means to build, maintain, and send ships into service for the country. Generations of sailors have carried this mission beyond the state’s borders—transforming it into a legacy.
And essentially, that history makes the Navy’s birthday an especially fitting occasion to remember those who served—not simply for the demanding assignments they completed but also for the resilience they demonstrated in facing the hazardous environments in their deployments.
Besides combat, a large part of the public was not aware that among the hazards military personnel correspondingly confronted in the earlier era was asbestos, a naturally occurring mineral. The fibrous material was previously prized for its durability as well as thermal properties, and was extensively incorporated into insulation, pipes, boilers, machinery, and other components aboard vessels.
Yet what made the material so versatile also made it dangerous: inhaling its microscopic fibers can lead to lung cancer up to 30 years later. For veterans in Baltimore who may have encountered asbestos during their service, that troubling reality deserves a place in discussions of early detection, particularly when screening criteria may not fully reflect the risks from years spent in service.
Why Baltimore’s Asbestos Legacy Still Matters for Veterans’ Lung Health
Currently, more than 21,300 veterans call Baltimore home, and among them are Navy personnel whose years in uniform may have exposed them to hazards that weren’t fully understood at the time. For many veterans, the consequences of service continue to unfold even decades later. That is because, according to research published by the National Institutes of Health, asbestos remained a staple in naval construction and maintenance before 1980—including at Naval Air Station Patuxent River, just a nearly two-hour drive from the city. Unfortunately, by the time medical science discovered asbestos as a potent human carcinogen, exposure had already occurred on a large scale.
An updated interactive map indicates that from 1999 through 2017, an estimated 5,236 residents in Maryland died of asbestos-related illnesses, wherein 689 died from asbestosis, 916 from mesothelioma, and 3,664 from lung cancer. Baltimore alone comprised 600 fatalities.
What makes these statistics stark is not just the number of lives lost but the disease that substantially exceeded the casualties of either mesothelioma or asbestosis: lung cancer. And this challenges the inclusion of asbestos exposure in the criteria for early lung cancer screening.
Looking Beyond Smoking When Assessing Veterans’ Lung Cancer Risk
Lung cancer screening has centered on smoking because tobacco use remains the leading recognized risk factor for the illness. That focus, however, can make other significant asbestos exposures easier to overlook—particularly when they occurred decades earlier and during military service. In fact, until now, the US Preventive Services Task Force only advises the annual low-dose CT screening for adults ages 50 to 80 who have at least a 20 pack-year smoking history—regardless of whether they still smoke or have quit within the past 15 years.
Typically, this recommendation would receive an A or B grade. These guidelines have helped identify who may be more at risk; however, they also underscore that a record of asbestos exposure by itself does not qualify individuals for this life-saving test. And that disparity affects veterans who had contact with asbestos during their service but never accumulated the smoking period required to qualify for screening. It is why military exposure history must be an essential part of the principal criteria currently used for testing.
Taking it into consideration can help physicians and veterans have more informed conversations about individual risk and earlier detection testing for lung cancer. As the country marks the Navy’s birthday, celebrating those who served means remembering not just where their service took them but also the conditions under which they fulfilled duty. More importantly, for veterans who may have encountered asbestos, keeping their exposure in dialogues about lung health is one meaningful way to pay tribute genuinely.
Cristina Johnson is a Navy veteran advocate at the Asbestos Ships Organization, a nonprofit that raises awareness about toxic exposure on Navy ships.
Cristina Johnson is a Navy veteran advocate for the Asbestos Ships Organization, a nonprofit educating veterans about the risks of asbestos exposure on Navy ships.