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Lung Cancer: Causes and Prevention

Jessica Evert, MD, edited by Benjamin McDonald, MD

person smokingResearch has revealed a number of risk factors which make it more likely that someone might get lung cancer. As is the case with many illnesses, some of the risk factors are avoidable, and some are out of people's control. People who are serious about lowering their risk for lung cancer can make it a goal to avoid as many of the following risk factors as is reasonably possible for their situation.

Smoking and Exposure to Passive Smoke. If you can do only one thing to reduce your risk of lung cancer, that one thing should be to stop smoking yourself (if you are a smoker) and to get yourself away from sources of secondhand smoke (if you live or work around smokers). Tobacco smoke, which contains cancer-causing chemicals (carcinogens), is the leading cause of lung cancer.  Most cases of lung cancers in both men and women are linked to the smoking of tobacco. People regularly exposed to secondhand smoke also appear to be at an increased risk for developing cancer.

The risk of cancer created by smoking is roughly in proportion to the intensity of someone's smoking habit. For example, someone who smokes a pack of cigarettes a day for 15 years is at a greater risk than someone who has smoked two cigarettes a day for the past three years. Though the risks are smaller when less tobacco is smoked we need to be clear that any regular smoking raises cancer risks well above the level of those who do not smoke at all.

Some smokers tell themselves that it is already too late for them to avoid disease, and so they may as well keep smoking. This is not true. People who quit smoking drastically reduce their lifetime risk of lung cancer and other diseases. Many hospitals, clinics, and employee assistance programs now can offer assistance to help people with the difficult task of quitting smoking.

Marijuana. Although marijuana is becoming increasingly legal in more locations, health experts are not yet sure whether using marijuana increases your chance of getting lung cancer. Marijuana smoke has many of the same carcinogens as cigarette smoke and often actually has more of those harmful chemicals. Marijuana is also smoked in a different way than cigarettes, which could pose risks to your lungs. In order to effectively reduce your risk of lung cancer, it is necessary to stop smoking of all substances, including marijuana.

Radon Exposure. Radon is a radioactive gas that is present in some rocks, soils, and building materials. People get exposed to radon gas when it seeps into the buildings where they live and work. Exposure to radon gas has been shown to increase a person's risk for getting lung cancer. Luckily, most people are not at substantial risk of being exposed to radon, which is commonly tested for in home inspections. Risk today is largely concentrated in occupations such as mining. It is important for anyone who is commonly exposed to radon in their working environment to wear a mask to protect their lungs from the gas.

Air Pollution. Some recent studies suggest that air pollution may contribute to lung cancer risk. However, these results are considered controversial. For those who do wish to avoid air pollution, it is not enough to simply 'move to the country' as the presence of nearby industry may render even rural areas polluted. Instead, consult a reliable resource that charts air quality, such as the EPA's AIRNow website (http://www.epa.gov/airnow/), to learn of areas with low pollution levels.

Asbestos. Asbestos is a fibrous mineral that used to be widely used as building insulation. It became a universally banned material when it became clear that asbestos fibers were carcinogens when breathed into the body. A history of regular unprotected exposure to asbestos raises an individual's risk of lung cancer moderately. Higher levels of risk occur when exposure to asbestos is combined with smoking. Although asbestos insulation is still present in some older buildings, it is not harmful until it is released into the air. Careful sealing over of installed asbestos insulation can provide protection for building inhabitants.

History of Lung Cancer or other Serious Respiratory Illnesses. People who have previously survived lung cancer are at higher risk of developing lung cancer again than are people who have never had the disease. Similar higher than normal risk for lung cancer occurs for people who have previously had serious respiratory illnesses such as tuberculosis (TB), or chronic obstructive, pulmonary disease (COPD).

Diet. It has recently been suggested that diets low in fresh fruits in vegetables can increase risk for lung cancer. This effect is probably due to the presence of vitamins and other nutrients found in the fruits and vegetables. The risk of a poor diet being associated with lung cancer increases when smoking is also present.

Genetic, Sex and Racial Factors. Lung cancer risk is also influenced by other factors including genetic, sex and race. Persons with blood relatives who had lung cancer, for instance, are at some increased risk of developing lung cancer themselves. Similarly, male smokers are roughly twenty times more likely to get lung cancer than men who do not smoke, while female smokers are only 10 times more likely to get the disease than women who do not smoke. African American men are noted to be at higher risk for developing lung cancer than are Caucasian men, although this disparity may be able to be accounted for more or less in terms of different cultural smoking habits within these groups.

It is important to remember that while having one or a combination of these risk factors makes you more likely to get lung cancer than someone else without those factors, it does not mean that you will get the disease. Risk factors aren't the whole picture; Individuals who have none of the risk factors for lung cancer may still become afflicted. In working to prevent lung cancer, it is best to eliminate the potential sources of risk from your life, and to not overly worry about what you cannot control.