Lung cancer not just smoker's disease: Oncologist lists risk factors, warning signs

The myth of the smoker-only disease

For decades, lung cancer has been stereotyped as a disease of smokers. But oncologist Dr Prriya Eshpuniyani is challenging that assumption. In a recent health advisory, she stresses that lung cancer does not spare non-smokers, and the risk factors go far beyond tobacco use.

India is witnessing a quiet shift in lung cancer demographics. Younger patients, some under 35, are being diagnosed without any history of smoking. This has prompted doctors to re-evaluate how the disease is detected and who should be screened.

Key risk factors beyond smoking

Dr Eshpuniyani points to several lesser-known triggers. Indoor air pollution from kitchen smoke, particularly in rural households using solid fuels, is a significant contributor. Outdoor air pollution, including traffic fumes in metro cities, also plays a role in damaging lung tissue over time.

Genetics cannot be ignored either. A family history of lung cancer raises susceptibility even in non-smokers. Exposure to second-hand smoke, radon gas, and occupational hazards like asbestos or diesel exhaust are additional red flags that are often overlooked.

The doctor's message is clear: if you have a persistent cough, chest pain, or shortness of breath, do not dismiss it just because you never smoked.

Warning signs that demand attention

Early symptoms can be subtle and easily mistaken for common respiratory infections. A cough that lingers for more than three weeks, coughing up blood, hoarseness, and recurrent pneumonia should prompt immediate medical evaluation.

Unexplained weight loss, fatigue, and bone pain are systemic signs that may indicate advanced disease. Dr Eshpuniyani advises that these symptoms, especially when combined with risk factors like pollution exposure or family history, warrant a thorough check-up.

She also notes that many Indian patients are diagnosed at late stages because symptoms are ignored or misattributed. This delayed diagnosis is a major reason lung cancer mortality remains high in the country.

Screening: a new approach for India

Traditional screening guidelines in many countries target long-term smokers above a certain age. But India's risk profile is different. Dr Eshpuniyani suggests that screening criteria must reflect local realities, including non-smoking-related risk factors.

Low-dose CT scans can detect lung nodules early, improving survival chances significantly. However, such scans are not yet widely accessible or affordable in India. The oncologist calls for greater awareness and policy attention to make early screening available to those at risk, not just smokers.

Health experts are also urging people to reduce exposure to indoor smoke and to wear masks in high-pollution areas. Simple lifestyle changes, combined with vigilance, can make a difference.

What lies ahead

Medical researchers are now studying how Indian-specific factors—such as biomass fuel use and urban air quality—affect lung cancer patterns. The hope is that future screening guidelines will be tailored to the country's unique demographic and environmental conditions.

For now, Dr Eshpuniyani's advice is straightforward: listen to your body. A persistent cough or unusual chest discomfort should never be ignored, regardless of your smoking history. Early detection remains the best defence against this deadly disease.