Cause of Death:
Lung Cancer

John Updike

Author, two Pulitzer Prizes

March 18, 1932 - Jan 27, 2009

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What We Know

There are many carcinogens in the 10,000 liters of air we breathe daily. These include both particulates and gases to which we are exposed indoors, outdoors and in the workplace. Although active smoking greatly increases the risk for malignant and nonmalignant respiratory diseases, there is a significant rise in lung cancer incidence in women who have never smoked. Worldwide, lung cancer kills over 1 million people each year. This sobering statistic underscores a major public health problem.

Research, dating back to the early 20th century, documents that inhaling environmental carcinogens causes lung cancer. Cancer of the lung was nearly nonexistent in the early 1900’s; however, by the middle of the 20th century an epidemic became apparent throughout the United States and the rest of the world. The annual incidence and mortality rate of lung cancer have increased more than any other malignancy.

Genetic Factors

The American Cancer Society estimates that smoking is directly responsible for 87% of lung cancer cases in the United States annually. However, all smokers do not get lung cancer. Moreover, being a non-smoker does not guarantee immunity to this potentially lethal disease. Genetic factors may determine susceptibility to environmental carcinogens. New research has begun to focus on identifying genotypes that are strongly associated with lung cancer risk. There is a substantial array of genes that may be relevant to lung cancer etiology, including those determining patterns of carcinogen metabolism and detoxification, susceptibility to DNA damage, and DNA repair.

Environmental Factors

Secondhand Smoke

Secondhand smoke, a major indoor air pollutant, is known as “environmental tobacco smoke” (ETS) or “passive smoking.” Second hand and even third hand smoke (in carpets, draperies and clothing) has also been implicated as causal agents in lung cancer. Secondhand smoke increases the risk of lung cancer in an exposed nonsmoker 2- to 3- fold. It is considered to be responsible for 1.6% of lung cancers in the United States.

Wood Smoke

Exposure to wood smoke may increase the risk of lung cancer. Converting from wood-burning stoves and fireplaces to other options, such as gas fireplaces, is one way to reduce this risk.

Radon

Exposure to radon in the home is the second leading cause of lung cancer and the leading cause in nonsmokers. Radon is a toxic radioactive gas that is produced by the natural decay of uranium in the soil and can seep through the cracks in the foundation of your home. An estimated one out of every 15 homes in the United States has radon levels above picocuries per liter (pCi/L), the U.S. Environmental Protection Agency-recommended action level. A recent report by the National Research Council estimates that radon is responsible for between 15,000 and 21,000 lung cancer deaths each year in the United States. Simple do-it-yourself test kits are available at most hardware stores or visit The Beverly Fund to request a free radon test kit.

Asbestos

Asbestos is responsible for roughly 84% of cases of mesothelioma, a cancer involving the lining of the lungs. Left alone, asbestos poses little danger, but harmful exposure can result if the asbestos is disturbed. When remodeling a home that may contain asbestos insulation, hire a certified contractor.

For a comprehensive resource pertaining to the devastating effects of asbestos, such as mesothelioma, please visit the Mesothelioma and Asbestos Cancer Resource and the Mesothelioma Center.

Air Pollution

Air pollution is a serious problem and a potential risk factor for developing lung cancer. In the largest study to date, more than 10% of lung cancers in Europe may be secondary to air pollution. Lung cancer is more prevalent in people in urban versus rural areas. Traces of cancer-causing dioxin including 2,3,7,8-TCDD, are found in both gaseous emissions and ash samples from incinerators across the country. Hazardous waste incinerators produce their own type of pollution, including new compounds, created by the process itself that can be more poisonous than the material fed into them. These include carcinogenic heavy metals, furans and dioxin. Other sources of air pollution are land fills and sewage treatment plants.

Industrial Chemicals

Occupational exposure to carcinogens is estimated to be responsible for 13% to 29% of lung cancers in men. Exposure to radiation, asbestos, chromates, arsenic, chloromethyl ethers, nickel, mustard gas, and emissions of coke ovens have been linked to some lung cancer cases. As with asbestos, most exposures to these cancer-causing chemicals occur in the workplace.

Chemicals in the Home

According to the EPA the air you breathe in your home is on average 4 times more polluted than the air you breathe outdoors. As many as 20 to 150 hazardous chemicals in concentrations 10 to 40 times those outdoors can be found in the typical American home. Household cleaning products, chemicals to mask odors, wood strippers, preservatives, pesticides, paints, hobby products, solvents, as well as personal care products may be the source of numerous potentially harmful elements. Chemicals in the fibers of new carpets and padding can give off volatile organic compounds. Unfortunately, there is a high incidence of lung cancer among carpet layers. Indoor pollution can cause allergic reactions, bronchial and pulmonary irritation and an increased risk of lung cancer.

Radiation Exposure

In general, the benefits of radiation exposure in the medical setting greatly outweigh the potential risks. For example, radiation therapy can play an important role in the treatment of many cancers (such as breast cancer and Hodgkin’s lymphoma), although such radiation may be associated with an increased risk of other cancers, such as lung cancer. Exposure to medical radiation to the chest for other cancers, for example Hodgkin’s lymphoma or breast cancer, can increase the risk of lung cancer, although the benefits of treatment usually far outweigh this risk. In Japan, exposure to atomic bomb radiation was associated with an elevated risk of developing lung cancer.