Lung cancer risks: The overlooked factors beyond smoking

When discussing lung cancer, smoking often dominates the conversation, and for good reason: it is the leading cause. However, many significant factors contribute to lung cancer risks that are frequently overlooked. In this article, we will explore these lesser-known causes and their impact.
Air pollution, particularly in the Delhi NCR region, presents a significant risk for lung cancer. High levels of PM2.5, fine particulate matter smaller than 2.5 micrometers, penetrate deep into the lungs and enter the bloodstream, leading to various health issues, including lung cancer. PM2.5 is classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), the same category as tobacco smoke. Even on its “cleanest” days, Delhi’s PM2.5 levels often exceed the World Health Organization’s safe limits, contrasting sharply with European cities, where air quality standards are significantly higher and strictly enforced.
While direct smoking is widely recognized as a major risk factor, other forms of tobacco consumption also contribute to lung cancer risks. Chewing tobacco and the use of e-cigarettes or vaping devices are becoming increasingly popular, especially among the younger urban population. Many young people mistakenly believe that vaping is a safer alternative to smoking. However, e-cigarettes contain harmful chemicals and carcinogens that can damage lung tissue and increase cancer risk.
Sick Building Syndrome (SBS) is another factor to consider. This condition occurs when occupants of a building experience acute health issues linked to time spent in the building, but no specific illness or cause can be identified. Poor ventilation, chemical contaminants from indoor sources like adhesives, carpeting, and upholstery, and biological contaminants such as mold and bacteria can contribute to SBS. While direct evidence linking SBS to lung cancer is limited, prolonged exposure to such environments can lead to respiratory problems that may increase the risk of cancer.
Radon, a colorless and odorless gas, is the second leading cause of lung cancer. It naturally emanates from soil and rocks, seeping into buildings through cracks and openings. Long-term exposure to high radon levels, especially in poorly ventilated spaces, significantly increases lung cancer risk. Unlike in Western countries, where radon mapping is common, India lacks comprehensive radon gas mapping of its cities, leaving many residents unaware of potential exposure. Testing homes for radon and taking corrective measures can mitigate this silent threat.
Asbestos, once widely used in construction, insulation, and various industries, poses another serious risk. Inhalation of asbestos fibers can cause lung cancer, as well as mesothelioma, a rare form of cancer. Though its use is now heavily regulated, older buildings and certain occupations still present exposure risks. Awareness and proper safety measures are crucial for those potentially at risk.
Genetics also play a role in lung cancer susceptibility. A family history of lung cancer can increase an individual’s risk, regardless of smoking status. Genetic mutations, either inherited or acquired, can predispose cells to become cancerous. Awareness of family medical history and discussions with healthcare providers about genetic testing can provide crucial insights and early detection opportunities.
Certain professions, particularly those involving exposure to carcinogens such as diesel exhaust, silica, and various chemicals, increase lung cancer risk. Occupational safety regulations and protective measures are essential to minimise these risks for workers.
In conclusion, while smoking remains a major risk factor for lung cancer, it is vital to recognize and address other significant contributors. Public awareness and proactive measures can help mitigate these overlooked risks, ultimately saving lives.
The author is Dr Vikas Goswami, Director – Medical Oncology (Head & Neck, Gastrointestinal, Urology, Musculoskeletal)
Disclaimer: The veracity of the claims made in this article is the responsibility of the hospital and doctor concerned.
(Partnered Content)