Prevalence Of Lung Cancer In India And Modalities Of Their Early Diagnosis

Lung Cancer is caused by the uncontrolled growth of cells that lead to tissue formation. Depending on how the cancer cells appear under a microscope, lung cancer can broadly be classified as small cell lung cancer or non-small cell lung cancer. According to the WHO, there have been 1.8 million deaths worldwide from lung cancer in 2020, making it the deadliest form of cancer. The mortality rate of lung cancer patients is high because of symptoms that do not appear until a late stage of the disease.

A report released by the Indian Council of Medical Research (ICMR) and the National Center for Disease Informatics and Research (NCDIR) in 2020 suggested that the cancer rates in India could increase by 12 per cent over the next five years. In 2021, the Indian Thoracic Journal1 found that 5.9 per cent of all cancer patients in India were diagnosed with lung cancer, which also accounted for 8.1 per cent of all cancer deaths in the country. This may be due to the increasing use of bidi in India, a form of raw tobacco; lack of awareness programs conducted at grass root levels; and the alarming rate of air pollution in the country.

Causes

About 27 per cent of all cancer diagnoses in India are related to tobacco use, which, allegedly, is the leading cause of cancer in India. Since lung cancer does not show any symptoms in the first stage, less than five patients with lung and stomach cancer have been diagnosed as local only (first stage). A hospital-based study has also found that approximately 90 per cent of India's lung cancer patients have been diagnosed with advanced stage cancer due to lack of diagnostic and awareness resources.

To reduce this issue in India, it is important to raise awareness at the grassroot level through encouraging people to stop smoking and providing access to appropriate testing infrastructure. Promoting regular health screening can play a major role in the fight against lung cancer, as data suggest that approximately 70 per cent of all cancers in India were protected by consistent risk factors.

Risk factors

The American Lung Association has recommended annual screening for people at high risk of developing lung cancer. According to them, if a person: 

a) is above the age of 55 years,

b) has a history of heavy smoking or currently smokes then an annual check-up is recommended.

If the scan shows any symptoms that may indicate the presence of lung cancer and subsequent tests may help confirm the diagnosis and give the patient the severity of the disease.

Diagnosis

Lung cancer can be diagnosed by the following ways, depending upon the doctor’s recommendation:

1. Image Test: This is an x-ray or CT scan which helps in detecting the abnormal weight or nodule.

2. Sputum Cytology: If a person produces sputum while coughing, they may have sputum sample tested to find out if there are any cancer cells.

3. Tissue samples (biopsy): Biopsies are performed using a variety of methods depending on the site of disease and the available infrastructure.

Conclusion

Careful analysis and diagnosis reveal what type of lung cancer is prevalent and helps in guiding the treatment. Numbers paint a sad picture, but we are making progress every day to give us better ways and procedures to diagnose the disease at early age. Until then, we need to be aware of and recognize the symptoms.

Dr. Vivek Nangia

Guest Author Dr. Vivek Nangia Director & Head, Fortis Lung Center, Fortis Hospital, Vasant Kunj, New Delhi He is a qualified Interventional Pulmonologist with more than 15 years of clinical experience (MD Respiratory Medicine, 1996). He has done his diploma in Interventional Bronchoscopies from Spain. He is amongst the pioneers to conduct various Bronchoscopic Interventions and Medical Thoracoscopy in Delhi. He has been a Visiting Fellow at the department of Pediatric Pulmonology, Royal Brompton Hospital, London He is one of the very few qualified Infectious Diseases Specialists in the entire country, having successfully completed a Diploma in Infectious Diseases from London School of Hygiene and Tropical Medicine (2008) first and then MSc in Infectious Diseases from London University, UK (2012). He has been awarded a fellowship by the American College of Chest Physicians, which is widely recognized, across the globe, as a mark of professional distinction He has keen interest in Sleep Medicine and has undergone training in Sleep Medicine at Stanford University, California, USA He is extensively trained in Critical Care Medicine and was a fellow in department of Pulmonary and Critical Care Medicine at Cleveland Clinics, Ohio, USA. His rich experience in critical care spans over nearly 15 years.