A Major Non-communicable Global Health Issue: Lung Cancer - Article Example

For many years, lung cancer was thought to be a disease common in man. However, in reality lung cancer is one of the most known causes of death amongmen and women smokers. There are two types of lung cancer: 1) Small cell lung cancer and 2) Non small cell lung cancer. Those who are diagnosed have usually the non-small cell cancer which, is caused by smoking and tend to grow as time passes by. Lung cancer has a poor survival prognosis. If lung cancer is not treated, it could have the most critical medical direction towards any category of pulmonary tumours. The symptoms of lung cancer are: a chronic cough, breathlessness which becomes worse during a course of time, weight loss, a continuous pain in chest or elsewhere. One of the most remarkable symptoms of lung cancer refers to coughing of blood by the patient. (NWRHC Health Center, 2006; Onganer, Seckl, and Djamgoz, 2005; Lung Cancer Symptoms, n.d.) Lung cancer usually occurs to people who are regular smokers and generally above the age of 50. Lung tissues are composed of cells that perform specific functions. When these cells are damaged lungs become vulnerable to cancer. (NWRHC Health Center, 2006) The more you smoke, the greater the risk of cancer. However, the risk decreases if a person discontinues smoking as new ones over a period of time replace the damaged cells. (“Lung Cancer - Non-Small Cell”, 2008) In the UK, around 40,000 people die of Lung cancer every year. (The Institute of Cancer Research, 2007) The government however, is trying to resolve this issue by passing laws such as imposing a ban on smoking in public places, non-hiring of personnel who are smokers. Though these laws are frustrating to many but it is the only way to make them quit this dreadful habit. According to the British Journal of Cancer, death due to lung cancer in the UK is expected to come down in the next five years. This is due to the health campaigners winning the war against tobacco use. However, the same cannot be said for many parts of Europe. Researchers in the UK predict that death from lung cancer among men under the age of 75 would decrease significantly by one in five. Researchers in the UK predict that death from lung cancer among men under the age of 75 would decrease significantly by one in five. Unfortunately, across Europe the anti-smoking message is falling on deaf ears. In France, lung cancer mortality, which is already higher overall than UK will increase by two percent in men and thirty one percent in women over a period of five years. Hungary, which is having the highest rates of lung cancer currently, is expected to increase further. Unlike the UK, many parts of Europe have failed in persuading people to give up the habit. This highlights the importance of internal collaboration in the ongoing battle against tobacco Industry. (Parsons, and Somervaille, 2000; Brennan and Bray, 2002) In 2000, the EPA, the WHO and the US Department of Health and Human services classified radon as a human carcinogen. Indoor radon exposure is the second leading cause of lung cancer. What is Radon? According to the American Cancer Society radon is a radioactive gas found in the soil of the earth. It is formed by the natural breakdown of radium. Radium is a radioactive substance emitted from decay of uranium. The risks of lung cancer enhances due to the presence of radon level at high levels at home and when exposure occurs for a long period. (NWRHC Health Center, 2006; Yarbro, Frogge, and Goodman, 2005, Radon, 2006) The World Health Organization has launched international awareness of radon. There are many other leading causes of lung cancer. Exposure to asbestos also leads to cancer. Other causes of cancer include uranium, arsenic and some petroleum products. Continued exposure to carcinogens leads to development of abnormal cells, which in turn becomes cancerous and forms a tumour. Studies have been conducted by researchers in Sweden to prove whether other environmental factors, including dietary factors also increase the risk of lung cancer. Many epidemiological studies have indicated that high intake of vegetables can be preventative measure. (Bashir, 2004) Even tea drinking has been associated with lung cancer. However, when test were conducted using a food frequency questionnaire, it showed that vegetables proved to be effective against lung cancer but tea had no effect. Milk, was considered to be a risk due to its fat content. (Larsson, Männistö, Virtanen, Kontto, Albanes, and Virtamo, 2008) Passive smoking, the uncontrolled method of smoking also causes cancer. Lung cancer is most likely to be common in developed countries, particularly in North America and Europe. However, it now subsiding in these parts and are rising in developing countries due to industrialization and tobacco use. Population exposed to radiation are also vulnerable to lung cancer. There are two types of radiation, which are categorised by their energy transfer rate to the tissue associated with lung cancer: low-linear energy transfer (LET) radiation for example x-rays, gamma rays and the second is high LET radiation for example neutrons and radon. Consequently, epidemiological studies reveal that air-pollution and lung cancer are also associated due to urbanization. (Persaud, Zhou, Baker, Hei and Hall, 2005) WHO statistics shows that developing countries have cancer rates approaching at higher level due to increase in industrialization and increase usage of tobacco. Lung cancer, which is increasing at an accelerated rate in most countries, is likely to become a ‘dominant cancer’ worldwide. (WHO, 1990) A comprehensive legislative and educational measure is required to control tobacco use and prevent lung cancer. To avoid cancer deaths avoid the use of tobacco, improve diet and physical fitness, lowering alcohol intake and eliminating workplace carcinogens. Asbestos, as mentioned earlier, is also a lung cancer agent. Mesothelioma a different form of lung cancer which is very difficult to cure occurs when we are exposed to asbestos working environment. In UK about 2-3 percent males are affected by this type of lung cancer. Around 2000 deaths took place in the UK caused by mesothelioma in 2005. Although there are many agents that cause lung cancer, smoking takes the number one position in all. It is by far the single most cause of premature deaths due to lung cancer. We are aware that that smoking is highly addictive and it is hard to quit once we start, despite the resources that are available to help assist us to quit. Smoking may be influenced by a range of different factors such as people’s social environment and level of education. Encouragement should not only be given to help quit but also to make sure that young men and women do not take up the habit in the first place only. As lung cancer is one of the most usual incidences in males and second most common in female in the UK, however, female lung cancer cases are rising steadily. (Parsons and Somervaille, 2000; Brennan and Bray, 2002) Women took to smoking later than men however the consumption of cigarettes continued to rise so that the decline in mortality rate was confined to younger women. India, Pakistan, Kuwait show an increase in lung cancer among men. Cigarette manufacturer continue to make high tar cigarettes and continue to market them in developing countries as developed are now taking steps to put a ban on smoking. Another factor to consider is air pollution. Even though it is known that cigarette is the leading cause of cancer and that occupational exposure also leads to lung cancer. However, we should also consider the fact that diesel-producing vehicles also deteriorate the air that we breathe, which might lead to damaged lungs. In England itself, death rates were higher in densely populated conurbations. (Court, 2002) A study was shown that immigrants from Britain to New Zealand, South Africa, Australia and Canada had higher death rates from lung cancer than the indigenous population of those countries. (Supramaniam, OConnell, Robotin, Tracey, and Sitas, 2008) Those who were age thirty and above fell into this category while those who were younger than thirty were not. This difference was not proved by their smoking habits and the importance to the environment exposure was given before migration. It was fashionable to speak of British Urban factor to which coal smoke pollution was an important contributor. Combustion products of fossil fuels in the ambient air, probably acting together with cigarette smoke acting together with cigarette smoke had been responsible for cases of lung cancer in urban areas. (Assessment of technologies for determining cancer, 1981) The increasing number of vehicles being manufactured and burning fuel may cause the air that we breathe to deteriorate further. Various study and research have come to the conclusion that sir pollution is not an important factor in the development of lung cancer. The possibility, particularly of its interaction with smoking cannot be ruled out. Dietary factors also relate to lung cancer namely fruits, vegetables and specific antioxidant micronutrients. Researchers have found these factors to have implication to prevent lung cancer. People who consume fruits and vegetables have a lower risk of developing lung cancer. However, much evidence is not found for fruit intakes Vegetables such a tomato and carrot is associated in lowering lung cancer. Modifying or changing eating habit seems a lot easier than changing smoking habits. Though the intake of fruits and vegetables, lower the risk of lung cancer quitting smoking lowers it even more. The intake of fruits and vegetables also helps us fight the other agents of lung cancer. Exercising and maintaining a proper dietary habit reduces the risk of lung cancer and also other chronic diseases as well. (“To Avoid Lung Cancer, Smokers should consume Fruits, Vegetables, Black and Green Tea”, 2008) Preventive strategies can be practiced such as tobacco control strategies, which include a ban on cigarette advertisement, children access to cigarettes and prohibiting cigarettes in workplaces. Legal proceedings against the manufacturers of cigarettes have also proven to be good way of tobacco control. A global priority is to prevent the pandemic of lung cancer, which is caused by the addiction of cigarettes. Preventing today’s youth from taking up smoking and effectively promoting smoking cessation among addicted smokers. (Alberg and Samet, 2003) There are other agents that spread lung cancer but fortunately they have been success to help prevent them in developed and developing countries. (McDonald, Colwell, Backinger, Husten, Maule, 2003) The ban that UK had put on smoking tends to decrease the prevalence of smoking and overall future trends rates in lung cancer. However, a similar law was passed in Ireland but only to have the smoking rates increased but again the smoking prevalence rates fluctuates from time to time. As we know that lung cancer has a poor survival prognosis this is due to the late diagnosis of the ailment and small proportion of people eligible for treatment and surgery. Though surgery is the only way to reduce lung cancer it has to be done at an early stage of the tumour. Lung cancer takes years to develop. Early diagnosis is complicated because many of the common indication of lung cancer are similar to those of smokers’ lung, which is chronic obstructive pulmonary disease. The first step to check for lung cancer is X-ray. If lung cancer is present, it needs to be at its minimum, a centimetre in terms of diameter to be detected by an ordinary X-ray. However, by the time a tumour has reached this size the original cell, which became cancerous, would have doubled by thirty-six times. Another method is bronchoscopy, which is direct investigation of the inside of the respiratory tubes with the help of a thin fibrous optic instrument using local anaesthetic. This is an important test for tumours in the bronchial space. It is crucial to understand which category of cancer a patient is afflicted with because small cell cancer shows utmost response towards chemotherapy while the non-small cancer is treated more efficiently using surgery. (Petrie, 2008; Stockley, Rennard, Rabe, Celli, Spiro, and McCaughan, 2007) As we know that smoking is the major factor relating to lung cancer. Some studies show that even though smoking has declined over the years, the rate of decline has been slower for women than men. (Moser, 1997) Nationally more women than men smoke in their teens and above forty. Data from west Midlands have shown that, from the age of 25, more women than men are smokers with the disparity increasing with age. Another study usually done by researchers is that of age-cohort model which, shows the incidence and mortality between and within countries. Preventing lung cancer is definitely a major task for the government. If only the steps taken to reduce or eliminate the exposure of people to the agents that cause lung cancer, then a major part would be solved. Cancer is the main area in the terms of the national target to increase life expectancy and bring down the distance between health inequalities. (Kuh, Ben-Shlomo, Lynch, Hallqvist and Power, 2003) A target was set for cancer mortality as a part to improve the health of the population. The target for cancer mortality was set as a part of a target to improve the health of the population, as measured by the increase in life expectancy. (UK Dept of Health). To combat the ailment of lung cancer and other smoking associated health problems the government has fixed a goal to bring down the rates of smoking in the UK to 21 percent by 2010 and also a reduction in the smoking prevalence which is the number of patients alive with cancer at a specific time, in routine or manual groups to 26 percent. (Möller, Shack, and Ashraf, 2006) The NHS stop smoking programs also support the initiation. However, the smoking prevalence in UK has fallen. The gap between men and women are narrowing and overall smoking prevalence is declining but the rate of decline kept slowing down. In 2004/2006 a huge number of smokers in the UK were in the age groups of 20 to 24 among which the number of women smoker was higher than that of men. Lung cancer takes time to develop, however, it is rare in young people and the rates increase in the age group of thirty-five to thirty nine. (Möller, Shack, and Ashraf, 2006) The incidence of lung cancer has decreased over time in all age groups for men. However, it has only decreased for those under seventy-five for women, the incidence rates in women kept increasing down the years this trend is due to the smoking up-take by women at a later age. Researches have created a number of models to show the incidence and prevalence rates of smoking in men and women. The incidence model shows that the trends in smoking are now becoming observable in the pattern of lung cancer rates in men and women, and will result in the marked shift of ailment between the genders in the next ten to fifteen years. If women can be persuaded to change their smoking habit, lung cancer cases per year might be prevented. This however would be only a small number and would only represent a small fraction toward our healthier nation. The focus for stop smoking and research and community based programs have given attention around adolescents, adult generally and pregnant women. The prevalence trends can be explained by the trends in incidence and survival over time. For both gender, forecasted prevalence differs most from incidence with increasing age. The fall in rates of lung cancer prevalent among male is generally lower or steeper that the reduction in prevalence among females, even though new cases are coming down, survival is improving. In female, the prevalence of lung cancer is forecasted to grow in all age bands at different rates. (Parsons, and Somervaille, 2000; Current Trends Decrease in Lung Cancer Incidence among Males -- United States, 1973-1983, 1986) Another model is that of age-cohort, here the approach taken is similar to many researchers who describe the patterns of cancer incidence and mortality between and within countries. (Kuh, Ben-Shlomo, Lynch, Hallqvist and Power, 2003) This modelling does not only help in providing information decision about health care planning but it might, as with lung cancer, help to bring attention to the population groups who might be at risk of the disease in the future. The data to show the trends of lung cancer in the developing countries are scarce but it is a fact that lung cancer continues to grow and if the developing countries follow the incidence and prevalence rate which was in the UK earlier than the cases for lung cancer would be enormous. A documented decrease in the mortality and incidence rates among men in the US and also a decrease in the prevalence. Several western countries have also reported a decline, particularly in the younger cohorts of men. Smoking in any form be it cigarettes, cigar or bidis (mostly in India) are associated with lung cancer. It is a misconception that low-tar cigarettes reduce the hazard of lung cancer. Only the complete annihilation of the product can save the population from the dreadful disease. If forceful worldwide tactics are not used to ban smoking then it is likely that within a decade lung cancer epidemic will be at high rise in developing countries and if we fail to win the war against tobacco we are condemning our future generations to absorb our loss and continue the fight. Future generation will look back on us and think why it took us so long to ban an obvious threat. Lung cancer rates and if possible tobacco consumption are best studied with different generation of the population, which is known as birth cohort method since smoking habits tends to be a characteristics of particular generation. US female will show a rising in smoking rates well into the next century. In most Mediterranean countries, smoking was usually a male habit until the recently and hence there has been minimal changes in the mortality rates among women. (Notani, 2001) In conclusion we can state that smoking is the main agent of lung cancer and though many countries have started the fight against it, we still need to develop a stronger and tougher law to eradicate this dreadful plague, which at present is targeting many younger youth in the developing nation. The government is launching many campaigns but even though millions are spend to do the same the message falls on deaf ears. The population is aware about the consequences and outcome of smoking a cigarette but still they don’t give up or complain that it tough to do so. There are many ways that cancer can be prevented, regular exercise and proper in take of food are couple of them. The Indian government had launched a campaign of putting pictures on cigarettes packets that showed the outcome of smoking but till date no action has been taken. In Singapore such practise is already there however, even these pictures are of no use in eradicating the habit of smoking. Huge revenues are collected through the sale of tobacco and alcohol hence it is difficult to abolish the company itself that manufactures them. It is up to the general smokers worldwide to have a strong will and to quit completely. References 1. Alberg, A.J. and J. M. Samet, 2003. Epidemiology of Lung Cancer,Chest. 123:21S-49S, available at: http://www.chestjournal.org/cgi/content/full/123/1_suppl/21S (accessed on August 15, 2008) 2. 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