Let’s clear the air about lung cancer.
For most people, the first thought that comes to mind on the subject of lung cancer is its relationship with smoking. Although lung cancer can often be synonymous with smoking, it is important to recognize that at least 1 in 10 people who have lung cancer have never smoked. There are a number of risk factors for lung cancer, such as: exposure to tobacco smoke, exposure to certain types of gases (inhalants), chronic lung disease, and family history of lung cancer.
According to experts, one of the challenges for diagnosing lung cancer includes the societal stigma of lung cancer, due to its association with smoking. While smoking remains the major risk factor, scientists continue to explore a better understanding of other risks associated with developing lung cancer.
About lung cancer
Lung cancer is the second most common cancer in both men and women in the United States and the most common form of cancer worldwide. As with most types of cancer, your risk increases with age. Most people who are diagnosed with lung cancer are over the age of 65.
Lung cancer is a serious diagnosis. It is associated with a high death rate because it is not usually discovered until it has spread to other organs. Symptoms, such as cough, chest pain, or shortness of breath, don’t usually begin until the cancer has progressed to advanced stages. While every case has unique features that affect survival, the majority of patients who are diagnosed with later stages of lung cancer will not survive one year after their initial diagnosis. If lung cancer is diagnosed early, it can be cured.
What are non-preventable causes of lung cancer?
If a close family member has had lung cancer, there is a chance that cancer can be inherited. Up to 8% of lung cancer cases are thought to be caused by genetic predisposition, meaning you may be more likely to get lung cancer because of your family history. Because there is a wide range of DNA mutations thought to be responsible for the development of cancer, no genetic test for screening is widely available.
If you already have a lung condition, like chronic obstructive pulmonary disease (COPD), asthma, or tuberculosis, you also have a slightly increased likelihood of developing the disease. While there are ways to mitigate the risk of cancer depending on the lung condition, people with these conditions have consistently higher rates of lung cancer than people who don’t have them.
What can I do to help prevent lung cancer?
Control your carcinogen (cancer-promoting substance) exposures:
- Quit smoking. Nearly 90% of lung cancer cases are caused by actively smoking. As evidence of the extreme harm from tobacco smoke, even those who have been exposed to secondhand smoke are at higher risk for the disease, accounting for more than 7,000 annual lung cancer deaths. The single most beneficial step for preventing lung cancer is to quit smoking. Your risk decreases each year after quitting. There are numerous evidence-based treatments, to help with tobacco and smoking cessation, that you can discuss with your healthcare provider.
- Avoid lung irritants. If you work around inhalants that have the potential to cause lung cancer, such as diesel fuel, coke, or asbestos, try to limit your time in proximity to these sources. While limiting exposure is the most effective way to prevent carcinogens from causing damage, if you are unable to avoid them, be diligent in wearing protective personal equipment, including appropriate respirators.
- Decrease radon exposure. Another environmental cause for increased lung cancer risk includes radon. Radon is an odorless gas released from radioactive particles in natural soil and rock. The most likely source for exposure is in the home. To test your home for radon levels, you can contact a qualified state radon tester, or order a kit online to be sent back for lab analysis through epa.gov/radon. Radon reduction systems help maintain lower levels of radon in buildings. Those who work underground, such as in mines, understandably undergo more exposure to radon than others. The Occupational Safety and Health Administration (OSHA) regulates allowable radon exposure levels in the workplace. If you have any concerns about exposures in your workplace, you should contact your worksite safety officer or health and safety department.
Exercise and Eat Healthy
As with most aspects of your health, eating well and physical exercise will go a long way in improving your long-term lung health.
Can I have a lung cancer screening?
Patients who are at high risk for developing lung cancer may be screened for lung cancer by their healthcare providers. Screening is performed by a low-dose CT scan (LDCT) of the chest. Risk of and benefits of screening must be weighed carefully. Lung cancer screening should be a decision determined by your healthcare provider and shared by you. Yearly scanning detects early lung cancer and prevents lung cancer death. One tool to understand whether you would benefit from LDCT lung cancer screening is available online at Saved By The Scan, from The American Lung Association.
In the United States, the Preventative Services Task Force is currently in the process of expanding its eligibility criteria for lung cancer screening. In a July 2020 draft, the task force outlined recommending those individuals age 50–80, with a 20-pack-year history of smoking, and less than 15 years since quitting smoking, to undergo annual LDCT scans. The draft recommendation is expected to be finalized later this year.
If you are concerned about your risk for lung cancer, either because of non-preventable or preventable risk factors, be sure to speak to your healthcare provider.
American Cancer Society, “Key Statistics for Lung Cancer,” January 8, 2020.
American Academy of Family Physicians, “USPSTF Recommends Lung Cancer Screening With Low-dose CT: Draft Recommendation Expands Eligibility Criteria,” July 15, 2020.
Electronic Library of Construction Occupational Safety & Health, “Diesel Exhaust,” Construction Safety Association of Ontario, 2002.
Frank C. Detterbeck, Sandra Zelman Lewis, et al., “Executive Summary, Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines,” Chest Journal 143, no. 5 (2013).
Anthony J. Alberg, Malcolm V. Brock, et al., “Epidemiology of Lung Cancer, Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines,” Chest Journal 143, no. 5 (2013).
Madiha Kanwal, Xiao-Ji Ding, Yi Cao, “Familial risk for lung cancer,” Oncology Letters 13, no. 2 (2016).
Jing-Yang Huang, Zhi-Hong Jian, et al., “The effects of pulmonary diseases on histologic types of lung cancer in both sexes: a population-based study in Taiwan,” BMC Cancer 15, no. 834 (2015).
American Cancer Society, “Lung Cancer Risk Factors,” October 1, 2019.
American Cancer Society, “Radon and Cancer,” September 23, 2015.
American Lung Association, “Lung Cancer Fact Sheet,” May 27, 2020.