Lung cancer: Knowledge application gap.

Sir,

Lung cancer is a leading cause of cancer death in both men and women. Lung cancer kills more people than any other cancer, a trend that is expected to continue until 2030, unless efforts for global tobacco control are greatly intensified.[1] Tobacco use is the most important risk factor for cancer causing 71% of global lung cancer deaths.[2]

In a prospective cohort study which assessed delay in diagnosis of lung cancer, it was concluded that lung cancer patients experience substantial delays from development of symptoms to first initiation of treatment and hence there is need to promote awareness of lung cancer symptoms and develop and evaluate rapid assessment clinics for patients with suspected lung cancers.[3]

Results from a UK based population survey[4] revealed low awareness of lung cancer symptoms and risk factors while in a study among residents of Pokhara Valley in Nepal, it was concluded that despite their awareness of smoking as a risk factor for lung cancer, most of them still continue to smoke.[5]

As lung cancer is to a large extent avoidable, preventive and control efforts should focus on all 3 major risk factors that are responsible for the rising incidence of lung cancer i.e., tobacco – all nations should ratify the WHO Framework Convention on Tobacco Control and implement the strategies that are part of convention, indoor air pollutants–by using improved stoves[6] and occupational carcinogens.

Table 1 shows some of the important problems identified with re gards to control of lung cancer and their possible corrective measures. Despite cancer being a global public health problem, many governments have not yet included cancer control in their health agendas. Incorporating cancer control programs in the public health system can consolidate the cancer control activities. Other measures include developing a sense of ownership among program managers; decision-making based on evidence and efficient and cost-effective use of resources that benefit the target population in a sustainable and equitable way.

Table 1

Measures for bridging knowledge-application gap

To conclude, multi-sectoral action is necessary at all stages to control rising trends of lung cancer because many cancer risk factors lie outside the health sector's direct influence. Planned interventions should be integrated as far as possible within the existing national health policies and health sector strategies. These interventions should be integral components of both the national cancer control program and the chronic disease control strategy.