Dr Prasanta Raghab Mohapatra, dean (academic), professor of pulmonary medicine and critical care at AIIMS Bhubaneswar , speaks to TOI about the risk factors of lung cancer
Is there any link between pollution and lung cancer?
The link between pollution and lung cancer is well-established, particularly concerning outdoor air pollution and exposure to fine particulate matter (PM2.5) and other harmful pollutants. Fine particulate matter (PM2.5), tiny particles that are less than 2.5 micrometers in diameter, can penetrate deep into the lungs and enter the bloodstream, and long-term exposure to high levels of PM2.5 is associated with an increased risk of lung cancer. PM2.5 is primarily produced by vehicle emissions, industrial processes, power plants and residential heating. Even prolonged exposure to nitrogen dioxide (NO2), a gas produced by burning fuel, has been linked to an increased risk of lung cancer since it contributes to respiratory inflammation and can aggravate pre-existing lung conditions. Others include ground-level ozone, industrial emissions like polycyclic aromatic hydrocarbons (PAHs) are known carcinogens, chemical pollutants, indoor air pollution, particularly from burning biomass fuels. Individuals working in sectors like mining, construction and manufacturing that have a high exposure to dust, fumes and chemicals are at an increased risk of lung cancer due to prolonged exposure to air-borne pollutants.
Air pollution causes chronic inflammation and oxidative stress in the lungs, leading to cellular damage, mutations and may cause cancer. Pollutants can directly damage DNA in lung cells, leading to mutations that trigger the uncontrolled growth of cancerous cells. Numerous studies have demonstrated a clear association between exposure to air pollution and increased lung cancer risk. WHO and the International Agency for Research on Cancer have classified outdoor air pollution and particulate matter as carcinogenic to humans.
Is there anything unusual that you see in lung cancer cases nowadays?
In recent years, there have been some unusual and emerging trends in lung cancer cases that differ from the traditional patterns typically associated with the disease. A growing proportion of lung cancer cases are being diagnosed in people who have never smoked. This trend is partly attributed to factors like air pollution, radon exposure and genetic predisposition. More and more younger patients are suffering from the disease which wasn’t the case several decades ago. While men traditionally had higher rates of lung cancer due to higher smoking rates, there has been a relative increase in lung cancer incidence among women, particularly non-smokers .
What is the status of lung cancer patients in AIIMS Bhubaneswar?
Over 2,000 cases were diagnosed in Bhubaneswar. Over the past decade, the numbers are increasing.
What steps can be taken to reduce the disease burden?
Reducing the disease burden of lung cancer requires a multifaceted approach involving early detection, effective treatment and supportive care. Implementing and promoting smoking cessation programs, including nicotine replacement therapy and medications, can help reduce the risk of lung cancer. Increasing taxes on tobacco products and enforcing strict regulations on advertising can help reduce tobacco use. We need to reduce exposure to air pollution by enforcing air quality standards and reducing emissions from vehicles and industrial sources.
Is there any link between pollution and lung cancer?
The link between pollution and lung cancer is well-established, particularly concerning outdoor air pollution and exposure to fine particulate matter (PM2.5) and other harmful pollutants. Fine particulate matter (PM2.5), tiny particles that are less than 2.5 micrometers in diameter, can penetrate deep into the lungs and enter the bloodstream, and long-term exposure to high levels of PM2.5 is associated with an increased risk of lung cancer. PM2.5 is primarily produced by vehicle emissions, industrial processes, power plants and residential heating. Even prolonged exposure to nitrogen dioxide (NO2), a gas produced by burning fuel, has been linked to an increased risk of lung cancer since it contributes to respiratory inflammation and can aggravate pre-existing lung conditions. Others include ground-level ozone, industrial emissions like polycyclic aromatic hydrocarbons (PAHs) are known carcinogens, chemical pollutants, indoor air pollution, particularly from burning biomass fuels. Individuals working in sectors like mining, construction and manufacturing that have a high exposure to dust, fumes and chemicals are at an increased risk of lung cancer due to prolonged exposure to air-borne pollutants.
Air pollution causes chronic inflammation and oxidative stress in the lungs, leading to cellular damage, mutations and may cause cancer. Pollutants can directly damage DNA in lung cells, leading to mutations that trigger the uncontrolled growth of cancerous cells. Numerous studies have demonstrated a clear association between exposure to air pollution and increased lung cancer risk. WHO and the International Agency for Research on Cancer have classified outdoor air pollution and particulate matter as carcinogenic to humans.
Is there anything unusual that you see in lung cancer cases nowadays?
In recent years, there have been some unusual and emerging trends in lung cancer cases that differ from the traditional patterns typically associated with the disease. A growing proportion of lung cancer cases are being diagnosed in people who have never smoked. This trend is partly attributed to factors like air pollution, radon exposure and genetic predisposition. More and more younger patients are suffering from the disease which wasn’t the case several decades ago. While men traditionally had higher rates of lung cancer due to higher smoking rates, there has been a relative increase in lung cancer incidence among women, particularly non-smokers .
What is the status of lung cancer patients in AIIMS Bhubaneswar?
Over 2,000 cases were diagnosed in Bhubaneswar. Over the past decade, the numbers are increasing.
What steps can be taken to reduce the disease burden?
Reducing the disease burden of lung cancer requires a multifaceted approach involving early detection, effective treatment and supportive care. Implementing and promoting smoking cessation programs, including nicotine replacement therapy and medications, can help reduce the risk of lung cancer. Increasing taxes on tobacco products and enforcing strict regulations on advertising can help reduce tobacco use. We need to reduce exposure to air pollution by enforcing air quality standards and reducing emissions from vehicles and industrial sources.
