Air Pollution & Smoking: Dual Threats To Lung Cancer Rise In India

The incidence rate of lung cancer rose from 6.62 per 100,000 in 1990 to 7.7 per 100,000 in 2019, with substantial increases anticipated in urban areas by 2025. Lung cancer is the primary cause of rising mortality in India among all types of cancers and its rate is highly impacted by the Air Quality Index. There has been a discernible increase in lung cancer incidence and fatalities in recent years, which is correlated with the growth in air pollution. Undeniably, smoking is a significant cause of lung cancer. However, in today's industrial world, air pollution has become one of the primary contributors of lung cancer cases. India ranked 5^th out of 118 countries in terms of highest air pollution levels in the world. According to a 2019 global survey, India is home to 21 of the world's 30 most polluted cities. Even nonsmokers are at significant risk of developing lung cancer due to air pollution. 

Although smoking's risk is linked to duration and intensity, poor air quality can be even more hazardous. Even people who do not smoke can significantly raise their chance of getting cancer by breathing in dangerous pollutants regularly when exposed to polluted air. Early-life lung cancer in children is more likely to develop as a result of air pollution. 

Ground-level ozone, particulate matter, carbon monoxide, sulfur dioxide, and nitrogen dioxide are the five main types of air pollutants. Lung cancer is specifically linked to particle pollution among all of these air contaminants. PM2.5 is a known lung carcinogen, and new research shows it may also raise the risk of other types of cancer, including heart-related risk. Due to its fine particulate size, PM2.5 can deeply enter the respiratory system and finally get into the bloodstream, contributing to widespread health issues beyond just lung cancer. 

Individuals should take the following measures to safeguard themselves against the risk of lung cancer: 

• People should schedule regular health check-ups to monitor lung health and detect any potential issues early. Stay alert to symptoms of respiratory issues and seek medical advice if needed.
• Wear protective masks as particulate matter-filtering masks (like N95 masks) when you must be outdoors on days when the air quality is unhealthy.
• Plan your outdoor activities at times when pollution levels are lower by frequently checking your local air quality reports and predictions.
• Stay away from tobacco and second-hand smoke to reduce your chance of lung cancer in general.
• Encourage the establishment and ongoing preservation of green spaces in metropolitan areas to help absorb toxins and purify the air in general.

• Improving air quality is crucial and involves implementing stricter regulations on industrial and vehicle emissions, investing in renewable energy sources like wind, solar, and hydro, and enhancing urban planning with more green spaces and better public transportation to reduce vehicle emissions.

By focusing on these areas, we can provide a comprehensive path forward to address the issue of rising lung cancer cases related to air pollution and contribute to a healthier future for affected populations.

The author is Medical Oncology & Haematology, Bone Marrow Transplant Physician, Sterling Hospitals, Vadodara.