AIRCARE Study: How Air Pollution May Be Increasing Lung Cancer Risk in India

As air pollution continues to worsen across India, its impact is no longer limited to respiratory problems—it may now be closely linked to rising cases of lung cancer. A new research initiative titled Air Pollution and Cancer Research Ecosystem (AIRCARE) aims to explore this connection in depth and generate India-specific scientific evidence.

India is home to some of the most polluted cities in the world, and experts say there is an urgent need to understand how prolonged exposure to polluted air is affecting long-term health. Lung cancer, already one of the most common cancers among men in India, is increasingly being diagnosed in non-smokers, particularly women and young adults—raising serious concerns.

Why AIRCARE Matters

The AIRCARE study, led by a team of researchers from AIIMS New Delhi, is among the first large-scale scientific efforts in India to evaluate the impact of air pollution—especially fine particulate matter (PM2.5)—on lung cancer risk.

The study will include over 1,600 lung cancer patients and an equal number of controls, primarily drawn from family members to ensure similar environmental exposure. The focus is to understand how long-term exposure to polluted air contributes to cancer risk and how it interacts with other factors such as lifestyle and genetics.

Speaking about the study, Dr. Abhishek Shankar, Assistant Professor, Department of Radiation Oncology, explained:
“The study aims to examine how prolonged exposure to PM2.5 contributes to lung cancer and to explore its interaction with other risk factors. Researchers will also assess vulnerable groups, including women, youth and non-smokers.”

Not Just Smoking Anymore

Traditionally, lung cancer has been strongly linked to tobacco use. However, experts say this perception is changing.

Dr. Sunil, Professor and Head of Surgical Oncology, highlighted the complexity of the issue:
“It is not appropriate to generalise broadly, as pollution varies in different forms and levels across places. Certain components of pollution are believed to increase cancer risk. One such component is PM2.5, but even within that there are several sub-factors.”

He added that researchers are now trying to identify which specific elements within pollution are most harmful, and whether similar health effects are seen in people living in the same environment.

This shift in understanding is important because it means that even people who do not smoke may still be at risk due to environmental exposure.

A Deeper Scientific Approach

What makes AIRCARE unique is its multi-layered research design. The study combines both clinical and non-clinical approaches, including cohort and case-control models, to track how chronic exposure to PM2.5 affects different groups over time.

Another key focus is to identify a possible genetic signature specific to the Indian population. Researchers aim to understand whether long-term exposure to polluted air triggers early genetic changes that may later develop into lung cancer.

This could help answer a crucial question: Why do some people exposed to pollution develop cancer while others do not?

Identifying High-Risk Groups

The study also aims to identify vulnerable populations who may be more at risk. Early observations suggest that:

* Non-smokers are increasingly being diagnosed with lung cancer

* Women and younger individuals are showing rising cases

* Urban populations may face higher exposure levels

By identifying these high-risk groups, the study hopes to support early detection and targeted screening strategies.

Towards Better Prevention and Screening

One of the long-term goals of the AIRCARE study is to develop a risk-based screening model tailored for the Indian population. This model will consider both clinical data and molecular findings, helping doctors identify individuals who may need early screening.

With the information gathered from these study arms, the investigators will develop a risk- based screening model based on both clinical and molecular components specific to the Indian population and exposure levels. It will also identify the susceptible population among the cohort who are more at risk of developing lung cancer.

Lung cancer continues to be the second most frequent cancer in males in India and the fourth most-common type for both sexes. Early detection remains a major challenge. Many cases are diagnosed at advanced stages, reducing the chances of effective treatment.

There is an urgent need to implement policy and management strategies to tackle this disease and mitigate further loss of life. The findings from this study could play a crucial role in shaping:

* Cancer prevention strategies

* Public health policies

* Screening guidelines

* Healthcare planning

Multiple Risk Factors Still Matter

While air pollution is emerging as a significant concern, experts stress that it is one of several risk factors.

Dr. Abhishek Shankar explained:
“To prevent cancer, the key approach is to avoid risk factors. Tobacco use alone is responsible for about 30 per cent of cancers in India. Infections like HPV, obesity, alcohol use, and hepatitis are also major contributors.”


He added that prevention strategies should include:

* Avoiding tobacco and alcohol

* Maintaining a healthy weight

* Getting vaccinated against HPV

* Managing infections that increase cancer risk

This highlights that while pollution is an important factor, a holistic approach to prevention is essential.

A Public Health Wake-Up Call

The rising link between air pollution and lung cancer signals a broader public health challenge. With increasing urbanisation, industrialisation, and vehicular emissions, exposure to harmful air pollutants is becoming a daily reality for millions.

Experts believe that without strong policy interventions and awareness, the burden of cancer linked to environmental factors may continue to grow.

The AIRCARE study is expected to provide much-needed evidence to guide:

* Environmental regulations

* Urban planning

* Public health interventions

The AIRCARE initiative marks a significant step towards understanding how air pollution is shaping India’s cancer burden. By combining scientific research with real-world data, it aims to bridge a critical knowledge gap.

As researchers work to uncover the link between polluted air and lung cancer, one message is clear: The air we breathe could be silently affecting our long-term health.