Increasing lung cancer cases in women ring alarm bells

Diana Wangari, CNS Special Correspondent, Kenya
(First published in The Star, Kenya) 
I remember one time when my grandmother paid us a visit in the city, she remarked on 'How the world has changed.' She was referring to a group of ladies, standing outside a restaurant who, while chatting, would pause every now and then to take a puff from the cigarette clutched between their meticulously manicured nails.

She then went on to explain how during her youth, one would not see a woman smoking, let alone a well educated woman (as these women obviously were), and certainly not in public. This was almost ten years ago and it was grandma’s  first time in the big city. But she did have a point. Women smokers was not something one could easily observe in developing countries such as Kenya-- not until recently. The situation was different in developed countries where a woman smoking in public is nothing to write home about and is a trend that had been on the increase. Subsequently, cases of lung cancer in women in these countries was higher than ttheir counterparts  in developing countries.

However, what does come as a surprise is the finding that lung cancer is now the leading cause of death in women in developed countries. According to the World Cancer Report 2014 by the International Agency for Research on Cancer (IARC), lung cancer has surpassed breast cancer--the change reflecting the tobacco epidemic which came to affect women later than in males.

In 2012, lung cancer was the most commonly diagnosed cancer, with 1.8 million cases worldwide, accounting for 13% of all cancer cases. Whereas approximately 70% of the world’s lung cancer burden can be attributed to smoking alone, second-hand smoke, also known as environmental tobacco smoke, has also been proven to cause lung cancer in nonsmoking adults.

Cancer now constitutes an enormous burden on society in more and less developed countries alike, and its occurrence is increasing because of the growth and aging of the population, as well as because of an increasing prevalence of risk factors associated with economic growth and urbanization, such as smoking, being overweight, physical inactivity, and changing reproductive patterns.

In less developed countries, lung and breast cancer are the most frequently diagnosed cancers and the leading causes of cancer deaths in men and women, respectively. In more developed countries, prostate and breast cancer are the most frequently diagnosed cancers among men and women, respectively, and lung cancer is the leading cause of cancer death in both men and women. Colorectal cancer has become a frequent cause of cancer death not only in developed countries, but also in developing countries.

Researchers point out that breast, lung, and colorectal cancers are increasing in many countries which are in economic transition with an already disproportionately high burden of cancers related to infection, including cancers of the liver, stomach and cervix. The worrying finding in the report indicates the already established relation between human behaviour, such as cigarette smoking in this case, and the increase in malignancies.

The report emphasizes that the global battle against cancer cannot be won with treatment alone and effective prevention measures are urgently needed to prevent cancer crisis. It further states that a number of cancers that were once rare in developing countries are becoming increasingly common there, as these countries adopt a more Western lifestyle. “A coordinated and intensified response from all sectors of society, including governments, civil society, the private sector, and individuals, is required to seize control of the growing burden of cancer,” the report says.

“Lessons from cancer control measures in high-income countries show that adequate legislation plays an important role in reducing exposure and risk behaviours. For instance, the first international treaty sponsored by WHO, the Framework Convention on Tobacco Control, has been critical in reducing tobacco consumption through taxes, advertising restrictions, and other regulations and measures to control and discourage the use of tobacco. Similar approaches also need to be evaluated in other areas, notably consumption of alcohol and sugar- sweetened beverages, and in limiting exposure to occupational and environmental carcinogenic risks, including air pollution”.

I could not help but remember my grandmother's remark and how in an effort to appear 'developed', we seem to be losing sight of the fact that not everything we adopt is beneficial. How long before, we start mirroring similar findings in Kenya?

It remains that a substantial proportion of the worldwide burden of cancer can be prevented through the application of existing cancer control knowledge, including tobacco control, vaccination (for example in cervical cancer), early detection, and the promotion of physical activity and healthy dietary patterns. And as my grandmother put it, "Our behaviour does define us."...even in health.
(First published in The Star, Kenya)

Diana Wangari, Citizen News Service- CNS,
19 February 2015