Prevention of lung cancer

Prevention[edit]

Smoking prevention and smoking cessation are effective ways of preventing the development of lung cancer.^[66]

Smoking ban[edit]

See also: Smoking ban

While in most countries industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the prevention of lung cancer, and smoking cessation is an important preventive tool in this process.^[67]

Policy interventions to decrease passive smoking in public areas such as restaurants and workplaces have become more common in many Western countries.^[68] Bhutan has had a complete smoking ban since 2005^[69] while India introduced a ban on smoking in public in October 2008.^[70] The World Health Organization has called for governments to institute a total ban on tobacco advertising to prevent young people from taking up smoking. They assess that such bans have reduced tobacco consumption by 16% where instituted.^[71]

Screening[edit]

Main article: Lung cancer screening

Cancer screening uses medical tests to detect disease in large groups of people who have no symptoms.^[72] For individuals with high risk of developing lung cancer, computed tomography (CT) screening can detect cancer and give a person options to respond to it in a way that prolongs life.^[57] This form of screening reduces the chance of death from lung cancer by an absolute amount of 0.3% (relative amount of 20%).^[73][74] High risk people are those age 55-74 who have smoked equivalent amount of a pack of cigarettes daily for 30 years including time within the past 15 years.^[57]

CT screening is associated with a high rate of falsely positive tests which may result in unneeded treatment.^[75] For each true positive scan there are about 19 falsely positives scans.^[76] Other concerns include radiation exposure^[75] and the cost of testing along with follow up.^[57] Research has not found two other available tests—sputum cytology orchest radiograph (CXR) screening tests—to have any benefit.^[77]

The U.S. Preventative Services Task Force (USPSTF) recommends yearly screening using low-dose computed tomography in those who have a total smoking history of 30 pack-years and are between 55 to 80 years old until a person has not been smoking for more than 15 years.^[78] Screening should not be done in those with other health problems that would make treatment of lung cancer if found not an option.^[78] The English National Health Service was in 2014 re-examining the evidence for screening.^[79]

Other prevention strategies[edit]

The long-term use of supplemental vitamin A,^[80][81] vitamin C,^[80] vitamin D^[82] or vitamin E^[80] does not reduce the risk of lung cancer. Some studies suggest that people who eat diets with a higher proportion of vegetables and fruit tend to have a lower risk,^[22][83] but this may be due to confounding—with the lower risk actually due to the association of a high fruit/vegetables diet with less smoking. More rigorous studies have not demonstrated a clear association between diet and lung cancer risk.^[83]