The Rise of Lung Cancer Among Non-Smokers: A Silent Urban Epidemic - Dr Amol Akhade

Lung cancer has traditionally been seen as a smoking-related disease, which has led people to believe it's a result of a person's own choices. But the reality of clinical practice is different: it shows a very distinct and alarming trend that more and more lung cancer cases arise from the population of non-smokers.

This trend, especially in cities, is like a silent but rapidly increasing epidemic. As a result, the oncologist community is witnessing an increasing number of young, healthy, and socially active people coming to them with the late stages of the disease, mainly because of the misinterpretation of their symptoms or simply neglecting them.

Urban Air Quality and Environmental Exposure:

The most important factor that has caused lung cancer in non-smokers is the long-term exposure of such people to air pollution. The air in the city now has a high level of particulate matter (PM2.5 and PM10), emission from the industry, and the exhaust of the cars.

These particles are very small and can even reach the inner parts of the lungs, thus causing chronic inflammation and damage to the cells. Over time this ongoing injury creates the environment of cancer development. The pollution from inside the house which includes the smoke of the fuels used for cooking in poorly ventilated houses is also increasing the risk, especially for females.

Genetic and Biological Factors:

Environmental factors increase the risk of disease and on the other hand, genetic factors play a determinant role in human susceptibility. For example, mutations of some genes like EGFR and ALK rearrangements are observed mostly in people who get lung cancer but have never smoked.

The study of these tumors shows that they are different from the ones that appear due to smoking and that they may have better chances of reacting to targeted therapies. But still, very few people have the knowledge and undergo early screening for such mutations which is why most of them are diagnosed at the late stages.

Delayed Detection and Misplaced Assumptions:

Non-smokers are thought to be at minimal risk which is why they usually neglect symptoms like continuous cough, tiredness, or shortness of breath and thus they do not ask for medical advice immediately. As a consequence, the diagnosis is made at advanced stages, where therapeutic approaches are complicated and the possibilities of recovery reduced, due to a late consultation.

Public education about the lung cancer risks of non-smokers should be the first step in the fight against this phenomenon. People need to be aware that lung diseases and air pollution are closely linked and the quality of air in cities also matters in this regard.

Besides that, educating people about the importance of paying attention to their health situation and their early check-ups as well as encouraging them to do so if they are high risk are the other components of comprehensive cancer prevention and control programs which should be revamped to tackle the current lifestyle realities.

Realizing this silent epidemic is a matter of time only and it cannot be delayed any further if we want to be in a position to safeguard people's health and save lives.

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