Cramer JD, Grauer J, Sukari A, et al. - A high risk for a second primary lung cancer was observed in head and neck cancer survivors. Thus, head and neck cancer survivors with a significant smoking history and who are fit to undergo curative treatment should undergo annual low-dose computed tomography (CT) chest screening for lung cancer.

• This ad hoc secondary analysis of a randomized clinical trial involved 171 survivors of head and neck cancer with a long smoking history, of whom 82 underwent lung cancer screening using low-dose CT of the chest and 89 with chest radiography (CXR).

• Incidence of a second primary lung cancer was the primary outcome.

• A higher lung cancer incidence was reported in head and neck cancer survivors vs participants without head and neck cancer (2.1% vs 0.6%; adjusted rate ratio, 2.54).

• The incidence of second primary lung cancer among head and neck cancer survivors was 2,610 cases per 100,000 person-years in the low-dose CT group vs 1,594 cases per 100,000 person-years in the CXR group (rate ratio, 1.55).

• An overall survival of 7.07 years with low-dose CT vs 6.66 years with CXR was noted in head and neck cancer survivors.