Lung cancer

Lung cancer is a malignant tumour of the lungs. Most commonly it is bronchogenic carcinoma (about 90%). Lung cancer is the most lethal malignant tumour worldwide, causing up to 3 million deaths annually.

Prevention

Primary prevention

Prevention is the most cost-effective means of fighting lung cancer on the national and global scales. While in most countries industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the fight to prevent lung cancer, and smoking cessation is probably the most important preventative tool in this process.

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Policy interventions to decrease passive smoking (e.g. in restaurants and workplaces) have become more common in various Western countries, with New York City taking a lead in banning smoking in public establishments in March 2003, and Ireland playing a similar role in Europe in 2004.

Related Topics:
Passive smoking - New York City - 2003 - Ireland - Europe - 2004

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Only the Asian state of Bhutan has a complete smoking ban (since 2005). In many countries pressure groups are campaigning for similar bans. Arguments cited against such bans is criminalisation of smoking, increased risk of smuggling and the risk that such a ban cannot be enforced. However, it should be noted that an illegal black market in tobacco would be much more difficult to operate, than with alcohol or marijuana. A cynical view taken by many campaigners is that losses in excise would harm government revenue.

Related Topics:
Bhutan - Smoking ban - 2005 - Criminalisation - Smuggling - Black market - Alcohol - Marijuana - Excise

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Screening and secondary prevention

Because prognosis depends heavily on early detection there have been several attempts at secondary prevention. Regular chest radiography and sputum examination programs were not effective in early detection of this cancer and did not result in a reduction of mortality.

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Computerized tomography (CT) scanning is now being actively evaluated as a screening tool for lung cancer, and it is showing promising results. The National Cancer Institute (USA) is currently completing a randomized trial comparing CT scans with chest radiographs. Several single-institution trials are ongoing around the world. A large group of investigators (the International Early Lung Cancer Action Project) are currently collating the results of 26,000 screen-detected lung cancers and are showing excellent preliminary survivals with these patients. More work is needed in this area.

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