By EDUARDO GONZALES, MD
Q: Is lung cancer the most common form of cancer in men? Is there a screening test for the disease that people can avail of? Are there things I can do to prevent the disease from affecting me? —firstname.lastname@example.org
Lung cancer is not the most commonly occurring cancer in men. That dubious distinction is held by prostate cancer. But lung cancer is the number one cause of cancer deaths in both men and women worldwide. The disease has a high mortality rate because it is often diagnosed at an advanced stage. The five-year survival rate for advance inoperable lung cancer is only one to five percent, but it is 40 to 50 percent for early stage lung cancer. Obviously, the odds of beating lung cancer are better if the disease is diagnosed early.
Who should undergo lung cancer screening?
The only available screening test for early detection of lung cancer is low-dose CT scan. In this test, an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lungs.
Unfortunately, although CT scanning itself is relatively safe, more than a quarter of people screened for lung cancer will show findings that lead to further testing that often involves invasive procedures such as biopsies and surgeries,which can result in permanent disabilities or even death.
In the National Lung Screening Trial, roughly one person died after an invasive procedure triggered by screening for every five to six lives saved because of screening.
Thus, the segment of the population for which lung cancer screening is currently recommended is a very small one—only heavy smokers who are between 55 to 80 years old. The targeted population takes into account the facts that lung cancer is predominantly a disease of the elderly—almost 70 percent of people diagnosed with the disease are over 65 years of age—and that about 90 percent of all lung cancers are caused by smoking or secondhand smoke (i.e., active or passive smoking). Specifically, you should undergo annual screening for lung cancer if you are 55 to 80 years old and you have smoked a pack or more of cigarettes per day for at least 30 years and currently smoking or have quit within the past 15 years.
Preventive measures against lung cancer
- The recommended screening guidelines and test for lung cancer will contribute, but only little (20 percent, at most), to decreasing the mortality rate from cancer. The most effective way to dramatically reduce deaths from lung cancer is in fact not early detection but prevention.
- There’s no sure way to prevent lung cancer, but you can reduce your risk if you:
- Stop smoking, i.e., if you smoke. If you don’t smoke, don’t start.
- Avoid secondhand smoke. If you live with a smoker, urge him/her to stop. Avoid designated smoking areas in restaurants, malls, etc.
- If you are exposed to carcinogens in your workplace, follow your company’s guidelines on how to minimize your exposure to them. Incidentally, the other known carcinogens (cancer-causing substances) aside from tobacco include asbestos, arsenic, chromium, nickel, and radon gas.
- Don’t take vitamin supplements, especially if you smoke. A reputable 2017 study showed that men who took high doses of vitamin B6 and B12 supplements had a 30 percent to 40 percent increased risk of lung cancer than those who did not take supplements, and the association was highest among current smokers.
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