‘Anyone with lungs can get lung cancer.’ What Georgians should know about the disease
Lung cancer is the third most common form of cancer among Georgians, according to the Centers for Disease Control and Prevention.
An Atlanta-based oncologist wants to educate people about their risks, especially non-smokers.
In 2019, people in Georgia died from lung cancer at a rate of 36 per 100,000 people, according to the most recent data from the CDC. About 56 people per 100,000 were diagnosed with lung cancer that same year, with prostate cancer being the most common followed by breast cancer.
Each year, more than 2 million people around the world are diagnosed with this disease, said Dr. Nitika Sharma, a medical oncologist and hematologist at Cancer Treatment Centers of America in Atlanta.
“And every day, about 300-400 people die of lung cancer,” she said. “That we believe — is equivalent to a Boeing 747 airplane crashing every single day.”
Although smoking is the most prevalent risk factor, Sharma said, about 20% of female patients and 9% of male patients with lung cancer are non-smokers.
“Anyone with lungs can get lung cancer,” she said.
Sharma spoke with the Ledger-Enquirer about the risk factors of lung cancer, how to detect it early and how it is treated.
The answers have been edited for clarity and length.
Q: What makes someone more at risk of getting lung cancer?
A: Smoking is the most preventable risk factor when it comes to lung cancer.
Other risk factors may include exposure to radon, asbestos, air pollution and secondhand smoking. With age, certain mutations can happen in an individual. Then there are other mutations that can occur, although they are less common with lung cancer.
Q: What makes treating lung cancer in non-smokers different?
A: Smoking does tend to portray a different biology to lung cancer. Whether a person has a history of smoking or not helps guide the clinician on what to expect with regards to the tumor biology.
There are certain mutations that can happen in lung cancer that tend to be more common in non-smokers, such as the EGFR mutation.
Now, if they look at somebody who has a history of smoking, there are certain mutations, such as the KRAS mutation, that tend to happen more frequently.
The treatment of lung cancer has moved beyond one size fits all. Because lung cancer is more genetically diverse than we previously suspected. It’s important to check for these mutations to understand what exactly is driving the lung cancer process, so the treatment can be precisely targeted to that particular individual’s cancer.
Q: What happens when someone is screened for lung cancer?
A: The screening is offered at your primary care physician, at a pulmonologist’s office, and we screen here at the Cancer Treatment Centers of America.
They go by your medical history, your age and your smoking history — the pack years.
If a person smokes one pack of cigarettes a day for 10 years then they have 10 pack years of smoking. If somebody smokes two packs of cigarettes a day for five years, then that is 10 pack years of smoking. That’s how we calculate the pack years.
We do a low-dose CT scan as part of the screening. Depending on what it shows, that helps the clinician guide the next step.
When should the next scan be? Does the scan show anything that needs immediate attention? Do you need a biopsy, or do you just need a follow up scan? Or is it all clear, and nothing suspicious showed up?
Q: When should people get screened for lung cancer?
A: One of the ways to lower mortality from lung cancer is by early detection, and early detection is done by screening.
Previously, screening guidelines identified anybody above the ages of 55 to 80 with a history of smoking at least 30 pack years and folks who were actively smoking or quit less than 15 years ago as a higher risk population.
In 2021, the lung cancer screening guidelines were updated. The minimum screening age moved from 55 years old to 50 years old and the minimum smoking history was reduced from 30 pack years to 20 pack years.
By lowering the bar, the new guidelines are trying to include more people in the screening population. Under the new guidelines, about 14.5 million Americans will be eligible for screening.
Q: What demographics are at a higher risk?
A: We know that Black Americans and women tend to see much greater impact tobacco use.
For example, if a woman has a smoking history of 20 pack years, compared to a man with 20 pack years, the woman is at a higher risk of developing cancer than the man.
So by expanding the criteria, the goal is to screen more of these minority populations. People can get screened, and that would increase the impact of screening in the general population.
It’s estimated that increasing the screening criteria saves an additional 10,000 to 20,000 lives each year.
Q: How important is early detection?
A: By doing this screening, we are trying to catch that suspicious lung at an early stage because what we know is if a cancer is detected at an early stage the outcomes are much better.
We know the survival is improved, and we can try to kill the cancer if it’s detected at an early stage, as compared to cancer that has spread.
This story was originally published October 17, 2022 at 12:14 PM.
