It is a common misconception about lung cancer across the globe and in India is that cigarettes are the only reason behind its occurrence. While smoking has been proven to be a major causative factor, it doesn’t necessarily mean that non-smokers are entirely safe from the often fatal pulmonary disease.
In fact, according to a study carried out by the Lung Care Foundation (LCF), it was found that the number of people with lung cancer consisted of individuals who smoke and don’t—and it was almost an equal representation.
A non-profit organisation whose objectives rest on the improvement of lung health in the country, LCF had recently conducted the study, and 150 lung cancer-afflicted patients from the Sir Ganga Ram Hospital in New Delhi, were part of it.
What they found in the results was quite unnerving—about 50 per cent of the sample size consisted of people who had never touched a cigarette in their lives!
This type of cancer has the highest stake in the annual number of cancer-related deaths in the country and if not just active or passive forms of smoking, then what else could be the cause of lung cancer that is claiming lives in such a prevalent manner in India?
We are sure that air pollution is the first thing that must have occurred to you, and your guess is not ill-placed.
“This is the first time I have seen this 1:1 ratio of smokers to non-smokers suffering from lung cancer. Looking at this data, the obvious reason that comes to mind is air pollution, which contains smoke and PM 2.5,” said Arvind Kumar, Chairman, Centre for Chest Surgery at Sir Ganga Ram Hospital to IndiaSpend.
Now, what is PM 2.5?
Less than 2.5 microns in size, these are particulate matter present in the air, that are known to cause lung cancer, cardiovascular and respiratory diseases, when inhaled in excessive quantities. They have already been classified as a cancer-causing agent by the International Agency for Research on Cancer (IARC), an auxiliary body under WHO in 2013.
If you remember, last year, the weeks following Diwali, were catastrophic for the residents of New Delhi. This was when its air quality index (AQI) had escalated to 999, which the Indian Medical Association equated to smoking 50 cigarettes a day.
The seeming connection between the national capital’s reduced air quality and the average number of deaths from lung cancer (which is higher than the national average) has valid subsistence. In fact, it has become a huge cause of worry for medical researchers and health workers in India because the ‘smoker’s disease’ is now being increasingly diagnosed in people below the age group of 50.
This was further verified in the study, in which nearly 21 per cent of the analysed patients were under 50 years old, out of which five were between 21 and 30 years of age (a total of 3.3 per cent of the total patient group). The data also showed that the number of women contracting lung cancer has increased considerably over the years.
An eye-opener in the study was that the number of patients with squamous cell carcinoma (SCC) in comparison to adenocarcinoma (AC) was relatively lower.
“Typically, smoking used to cause squamous cell carcinoma, but we now see an increase in women and younger people with mostly AC and this shows their cases are not related to smoking, but pollution,” added Kumar.
Furthermore, it has been verified by a 2016 paper in the European Respiratory Journal that the increasing number of patients with AC is directly associated with higher levels of ambient PM 2.5.
In the study, other reasons that point towards the incidence of lung cancer besides smoking, include exposure to radiation and asbestos, and occupational hazards attached to mining, in addition to environmental factors such as heavy air pollution.
But this can be prevented through early detection and screening.
It is often the lack of awareness along with late detection and misdiagnosis that leave most people to put themselves through the painful misery of awaiting their death.
Therefore, such studies should help open the eyes of concerned government bodies to understand what we have right now is a public health emergency and measures to tackle air pollution are the need of the hour.
(Edited by Gayatri Mishra)