Lung cancer is the leading cause of cancer deaths in males and the second leading cause in women. Until recently, it has been difficult to treat due to the fact that in many cases the diagnosis is not made until the disease is advanced. Often this is due to few or no symptoms in earlier stages of cancer growth.

The leading cause of lung cancer globally is tobacco smoking. Decreasing rates of smoking in the community will ultimately reduce the frequency of lung cancer-related deaths, after a long lag period; smoking cessation is the single most important public health intervention to reduce the lung cancer burden.

Over the past seven years, routine screening for lung cancer with low dose CT thorax has been implemented for earlier diagnosis in at risk individuals (smokers, >50 yo). There is a significant survival benefit with annual low-dose CT in this group.

Other risk factors

Note that not all lung cancers are strongly smoking-related. Other risk factors for lung cancer include asbestos exposure and/or prior radiation.

Lung cancer may present with a variety of symptoms including:

• cough
• coughing up blood
• shortness of breath
• wheeze
• chest pain
• reduced appetite/weight loss
• signs of chest infection.

Appropriate investigations include radiological imaging, breathing tests, blood tests and sometimes bronchoscopy. Fear of “something nasty” should not delay seeking medical advice; in fact, earlier diagnosis of lung cancer is better and more often than not the underlying cause of many of those symptoms is benign.

Treatment of lung cancer depends upon type and location. Surgical removal of early-stage lung cancer produces the best results. Fortunately, even in advanced lung cancer, newer treatments and treatment combinations (including chemotherapy, immunotherapy) continue to make a substantial difference to survival and quality of life.