What is most shocking and surprising is the fact that the number of non-smoking Indians suffering from lung cancer is now increasing at a rapid pace, even surpassing that of Westerners. This has been attributed to occupational exposure and polluted air.
Lung cancer is detected in Indians at a quite young age, states a report published by The Lancet. Normally, an Indian patient who suffers from lung cancer is at least ten years younger than his or her Western counterpart, and the disease largely affects non-smokers.
Dr. Sajjan Rajpurohit, Senior Director, Medical Oncology, Max Hospital, Shalimar Bagh, draws attention to the issue in an interview with HT Lifestyle.
He says, “Lung cancer, considered classically as a smoking-related cancer, is presenting a different and worrisome picture in India. In this country, up to a fair proportion of lung cancer patients never smoked—this is quite unlike the West where smoking remains the main villain.”
This phenomenon compels us to raise another question: why non-smoking Indians are more prone to lung cancer compared to their Western counterparts.
“Another factor at play is the highly unhealthy state of air in India, particularly in urban areas. Microscopic pollutants such as PM2.5 may deeply reach into the lungs, prolonging inflammation and damaging lung tissues. Long-term contact with these forms of pollutants could start mutations in lung cells that will finally lead to cancer—even among nonsmokers who inhale polluted air every day.
Although smoking rates in India are less compared to the West, second-hand smoke still poses a threat. Rounds at home due to exposures from family members or neighbors, coupled with public places, majorly contribute to lung cancer risks in non-smokers.
Genetic predisposition to lung cancer is another factor. Some studies suggest that certain gene variants might be associated with increased risk among non-smokers exposed to environmental carcinogens.
In India, lung cancer presents a decade earlier than in Western countries. The patients are relatively young with a mean age of diagnosis of 54-70 years versus 60-70 years in the West. The awareness is lower, and diagnostic facilities are limited, resulting in delayed diagnosis that affects the treatment outcomes. This widening gap in the rates of lung cancer in nonsmoking Indians, compared to those in Western countries, raises the need for increased awareness, better diagnostic facilities, and stringent measures to combat air pollution and secondhand smoke exposure.
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