The use of tobacco is widely understood as a risk factor for the development of lung cancer. However, in the National Capital Region (NCR), doctors report rising rates of lung cancer among non-smokers.
“When I started operating on cancer patients in 1988, I found their lungs were pink,” Dr Arvind Kumar, chairman of the Centre for Chest Surgery at Sir Ganga Ram Hospital, said at a recent conference in Delhi. “At the time, ninety percent of the lung cancer patients were smokers and the rest non-smokers. Now, the ratio stands at fifty-fifty. Half my cancer patients are non-smokers. Worse, the lungs of almost all patients are dotted with black spots.”
Such a trend has been observed for some time. Lung cancer affects two million Indians yearly. The disease accounts for 7.5 percent of the overall cancer burden in the country and ten percent of cancer-related deaths. While tobacco use in India is high, it can no longer be said to be the predominant driver of lung cancer in the country as people who have never smoked are falling prey to the disease in increasing numbers. A fifty-fifty ratio as expressed by Dr Kumar is a clear indication that the health challenges of pollution are multiplying, driving an explosion of noncommunicable diseases in the country.
Past research at the Sir Ganga Ram Hospital similarly found that fifty percent of cancer cases there were found in non-smokers. Kumar, who led the study, said at the time “decades back, lung cancer cases were attributed to smokers and old age groups. [This] is changing rapidly. In our study, the ratio of smoker to non-smoker was found to be 1:1 as opposed to all earlier reports.” His more recent remarks suggest that, since that research was conducted last year, little seems to have changed.
It is unsurprising that this is the case. Kumar expressed in 2017 that breathing the air in Delhi was the equivalent of smoking fifty cigarettes a day. The health effects of long-term exposure to air pollution is perhaps best gauged by the fact that even a short stay in a city as polluted as India’s choking metros causes respiratory issues – insinuative of the catastrophic impact upon the health of those who live there and so are exposed to such pollution on a daily basis.
Such trends cannot be assumed to be limited to Delhi. Other cities are witnessing surges in respiratory illness in tandem with plummeting air quality. As well as lung cancer, India is witnessing increasingly high rates of chronic obstructive pulmonary disease (COPD), asthma, and cardiovascular diseases, all of which can be linked – at least in part – to its air emergency.
With even those in good health negatively affected by the pollution, those who are immunocompromised, experience pre-existing conditions, the young and the elderly are far more susceptible to its effects. Nationwide, 1.2 million people lost their lives to pollution in 2017. As experts warn of a lung cancer epidemic in the country, even among non-smokers, India cannot afford to ignore the patent and manifold health risks of air pollution and the need to tackle the emergency.