Lung cancer rates among non-smokers in India soar faster than Westerners: Understanding the difference | Health

In a study published in the Lancet, lung cancer Lung cancer is diagnosed at a young age in India. Surprisingly, the average age of an Indian with lung cancer is at least 10 years younger than their Western counterparts. Lung cancer can also occur in non-smokers. (Read also: World Lung Cancer Day: 6 non-smoking risk factors for lung cancer)

Talking about this, Dr Sajjan Rajpurohit, Senior Director, Medical Oncology, Max Hospital, Shalimar Bagh, in an interview said, “Though lung cancer is a disease traditionally associated with smoking, India presents a unique and alarming situation. Here, a significant proportion of lung cancer patients have never smoked. This is unlike the West, where smoking remains the primary cause. This phenomenon should draw our attention and raise the question as to why non-smoking Indians are more susceptible to lung cancer than their Western counterparts.”

Air pollution: the silent killer

India suffers from severe air pollution, especially in urban areas. Fine pollutants such as PM2.5 (particulate matter less than 2.5 microns in diameter) penetrate deep into the lungs, causing inflammation and damaging lung tissue. Chronic exposure to such pollutants leads to mutations in lung cells and ultimately to cancer. The risk is significant even for non-smokers who breathe polluted air every day.

Occupational hazards

There are many occupations in India that expose workers to lung carcinogens (substances that cause cancer). These include asbestos, chromium, cadmium, arsenic, coal dust, etc. Workers in mining, construction and certain manufacturing industries are at even higher risk.

Passive smoking

Although smoking rates are lower in India than in Western countries, exposure to passive smoking remains a major threat – at home, by family and neighbours and in public places – and can increase the risk of lung cancer in non-smokers.

Genetic predisposition

Genetic makeup can influence lung cancer susceptibility, and studies suggest that certain genetic mutations may increase risk in non-smokers exposed to environmental carcinogens.

Early onset and diagnostic challenges

In India, lung cancer often develops 10 years earlier than in Western countries, meaning patients are generally younger, with the average age at diagnosis being 54-70 years compared to 60-70 years in Western countries. Moreover, low awareness and limited access to diagnostic facilities can lead to delayed diagnosis, affecting treatment outcomes.

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