Primary prevention

 

Smoking cessation or avoidance of smoking is the most effective measure for preventing lung cancer. Smoking cessation at any age is beneficial to health of all smokers. An individual’s risk of lung cancer would drop by about half that of a smoker 10 years after quitting smoking. A prospective study of one million women in the UK found that former smokers who stopped smoking at about 30 and 40 years of age had their risk of dying from lung cancer reduced by 97% and 90%, respectively.

 

Avoiding or reducing exposure to known carcinogens such as asbestos, radon and radiation in occupational setting by following recommended occupational safety practices (such as wearing protective gears) would result in a decrease in the risk of developing lung cancer.

 

A World Cancer Research Fund (WCRF) International systematic review and meta-analysis observed an inverse association between fruit and vegetable consumption (up to 400g/day) and lung cancer risk, but it is difficult to exclude residual confounding by smoking. Despite the potential protective effect by diet rich in fruits and vegetables, smoking cessation remains the most important intervention to reduce the risk of lung cancer.

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Early Detection

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In the early stages, lung cancer usually has no noticeable symptoms. Symptoms of lung cancer include persistent cough, haemoptysis, recurrent or persistent chest infections, hoarseness, chest discomfort or pain when coughing or taking a deep breath, loss of appetite and weight, and fatigue. Individuals with suspicious symptoms should seek medical assessment and investigation promptly.

 

Screening 

 

Screening for lung cancer aims to identify asymptomatic persons having early stage disease so that early treatment can be offered. Currently, three screening modalities are being used to different extents, namely chest X-ray, sputum cytology and low-dose computed tomography (LDCT, sometimes known as low-dose CT).

 

To increase the yield of any screening test, screening is generally offered to those considered at high risk of developing the disease. As tobacco smoking is the biggest single risk factor for lung cancer, screening is often considered for individuals with a significant history of heavy smoking [measured in ‘pack-years’ = number of packs of cigarettes smoked per day x number of years smoking].