Dr. Pavan Yadav, Lead Consultant – Interventional Pulmonology & Lung Transplantation, Aster RV Hospital
Lung cancer remains one of the leading causes of cancer-related mortality worldwide and is especially concerning in India, where rising rates of air pollution, high smoking prevalence, and limited awareness contribute to the growing number of cases. A concerted effort to enhance awareness, prevention, and early detection of lung cancer can significantly impact public health outcomes in India.
The Growing Burden of Lung Cancer in India
Lung cancer ranks among the top five most common cancers in India and is notably more prevalent among men. Each year, India reports approximately 75,000 new cases, with a considerable number diagnosed at advanced stages. The mortality rate remains high due to delayed diagnosis and limited access to advanced treatment, particularly in rural areas. Additionally, lung cancer’s silent nature – where early symptoms are often subtle or mistaken for less severe conditions – means that many cases go unnoticed until they reach a more critical stage.
Causes of Lung Cancer: Not Just Smoking
While smoking is the leading cause of lung cancer globally, attributing to nearly 85% of cases, it is not the only cause. In India, where urban pollution levels are among the highest in the world, non-smokers are increasingly affected by lung cancer due to environmental factors. Outdoor air pollution, primarily from vehicular emissions, industrial pollutants, and construction dust, has been recognised as a serious risk factor. Moreover, household air pollution from burning solid fuels like wood or coal for cooking and heating significantly increases lung cancer risk, particularly for women in rural India who spend prolonged periods in smoke-filled kitchens.
Occupational hazards also play a role. Workers in industries like mining, construction, and manufacturing may face exposure to carcinogenic substances like asbestos, silica dust, and diesel exhaust. This occupational exposure further increases lung cancer risk, emphasising the need for safety measures and regular screenings in high-risk jobs.
Symptoms and the Importance of Early Detection
One of the greatest challenges in combating lung cancer is its late diagnosis. Early-stage lung cancer often presents mild or non-specific symptoms, such as a persistent cough, chest pain, shortness of breath, and unexplained weight loss. As a result, these symptoms are frequently misinterpreted as signs of less severe respiratory issues or even ignored.
Early detection is critical, as it can significantly improve survival rates. According to studies, if lung cancer is identified at an early stage, the five-year survival rate can increase by up to 60-80%, compared to less than 15% at advanced stages. This makes screening a powerful tool, especially for high-risk groups such as heavy smokers, people with a family history of lung cancer, and those exposed to significant air pollution or occupational hazards.
Prevention Strategies: What Can We Do?
- Anti-Smoking Campaigns: Reducing smoking rates is critical. Individuals who quit smoking can reduce their risk of lung cancer significantly over time, with risks decreasing by about 50% after five years of cessation. Initiatives aimed at tobacco cessation, particularly among young people, must be strengthened.
- Reducing Indoor Air Pollution: The shift toward cleaner cooking fuels, such as LPG or electricity, particularly in rural areas, can help reduce household air pollution. Programs like the Pradhan Mantri Ujjwala Yojana, which provides LPG connections to low-income households, are positive steps, but their expansion and accessibility need to be further promoted.
- Tackling Outdoor Air Pollution: Public policies targeting vehicular emissions, industrial pollution, and waste burning must be prioritised. The effects of air pollution on lung health are far-reaching, and efforts to improve air quality can lower lung cancer incidence, especially among non-smokers.
- Workplace Safety: Employers in industries with exposure to carcinogenic substances should be held accountable for implementing safety measures, including protective equipment and routine health check-ups for their employees. Workers, too, must be informed about the risks and encouraged to participate in preventive health programs.
Despite the challenges, there is reason for hope. Advances in lung cancer treatments, such as immunotherapy and targeted therapies, have brought new options to patients, especially those diagnosed at later stages. India’s healthcare system has made strides in making these treatments more accessible, though further work is needed to reduce disparities.
Additionally, research into lung cancer causes and treatment continues to expand, bringing potential breakthroughs that may further improve outcomes in the future. For example, recent studies are exploring how genetic factors may contribute to lung cancer in non-smokers, which could lead to more personalised prevention strategies.