Tobacco use is the preventable cause of cancer in the world. Estimates suggest that approximately one-third of all cancers are caused by tobacco use. In South Africa, lung cancer features among the top cancers in the country.
In support of World Lung Cancer Day on 1 August, the Protect our Next partner organisation, Cancer Association of South Africa (CANSA) is calling for more awareness and understanding of lung cancer risk factors, particularly smoking, as well as emphasising the importance of screening and early detection. “The best way to lower your risk of lung cancer is to avoid tobacco smoke completely. It’s never too late to stop smoking, but the sooner you stop, the better,” says Lorraine Govender, National Manager: Health Promotion for CANSA.
According to the World Health Organization (WHO), lung cancer is responsible for nearly one in five cancer deaths. While lung cancer and breast cancer are diagnosed at the same rate (11.6 percent), lung cancer kills more people yearly than breast, colon and prostate cancers combined. Lung cancer mortality is projected to reach 2.45 million by 2030, a 39 percent increase in just over a decade.
Smoking is the single greatest risk factor for lung cancer at a whopping 80 percent of all cases. Still, the Tobacco Control Data Initiative shows that 33.6% of men (about 5.4 million people) and 6.9% of women (about 1.3 million) smoked cigarettes in 2017 in South Africa.
According to a 2020 research report, the incidence of lung cancer in South Africa is probably underreported. Access to screening options and education is vital for early detection and treatment. Low-income countries, where survival rates are significantly below the average, report only a 15 percent availability of treatment through public health systems. While South Africa is classified as an upper middle–income economy, high levels of inequality contribute to different risk profiles in various population groups.
Patients in the public sector often present with advanced disease. Possible reasons include lack of education, difficult access, and delayed referrals. CANSA plays a vital role in assisting with providing support for cancer research, education of the public regarding symptoms, early detection, screening, and risk reduction. CANSA also runs an online programme called eKickbutt which also provides support and information for smokers who would like to stop smoking on http://www.ekickbutt.org.za/.
Lung cancer symptoms include change in mucus, chest or back pain, coughing up blood and difficulty swallowing. Tests that may be used to diagnose lung cancer include chest x-rays, CT and PET scans, bronchoscopy and needle biopsies. Current or former smokers or those over the age of 55 may be candidates for a low-dose CT scan screening that can detect lung cancer in its earliest stages.
Govender says, “Thousands of harmful chemicals are present in tobacco and particularly in tobacco smoke, which has documented serious adverse health effects. There are 70 known carcinogens in cigarette smoke including nitrosamines, polycyclic aromatic hydrocarbons, benzene, cadmium, toluidine, and vinyl chloride. However, tobacco remains a widely and legally available product which, through the drug nicotine, is highly addictive and is promoted by a powerful and highly profitable industry. It has several marketing advantages over other addictive drugs. Other addictive drugs are mostly illegal, their method of administration is often by injection, they are socially disruptive, and they have very low social acceptability. In contrast, tobacco use has been the norm in the past and still has social acceptability in certain societies.”
What can be done to curtail tobacco use in South Africa? Govender highlights that The World Health Organization (WHO) has validated several strategies which are effective in curtailing the use of tobacco. “One of the methods cited is the implementation of smoke-free legislation to prevent exposure to second-hand smoke (SHS) as it is also important in preventing cancer, because SHS is also a known contributor to cancer development. As SHS is a definite cause of cancer and is defined as Class 1 carcinogen by the International Agency for Research on Cancer, the importance of smoke-free policies for cancer prevention is high,” adds Govender.
The number of specific cancers linked to second-hand smoke is clear, but smoke-free policies also have other benefits that ultimately prevent cancer, according to Govender. “These policies discourage young people from starting to smoke, encourage smokers to quit, and help former smokers stay off smoking. Smoking has often been regarded as a normal social activity despite the fact that it is addictive, is a cause of great inequality, and contributes significantly to disease, disability, and death. Smoke-free policies achieve a positive effect through educating people about the health benefits, limiting opportunities to smoke, and promoting an attitude of denormalization of smoking.”
Govender explains the new Control of Tobacco and Electronic Delivery Systems Bill will make it easier for South Africans to choose smoke-free lives, regulate the danger of e-cigarettes and decrease the impact of second-hand smoke on the majority of the population, who are non-smokers. United through the Protect our Next initiative, the National Council Against Smoking (NCAS), the Cancer Association of South Africa (CANSA), the Heart and Stroke Foundation South Africa (HSFSA) and the South African Medical Research Council (SAMRC) are steadfast in campaigning for the new Bill to be passed.
“It’s time for our people and our government to show leadership in implementing global best practice to curb the onslaught of big tobacco, and the industry’s ongoing impact on diseases like lung cancer,” says Govender.
CANSA runs an online programme which also provides support and information for smokers who would like to stop smoking on http://www.ekickbutt.org.za/.
Call the National Council Against Smoking - Quitline at 011 720 3145 for tips to help you stop smoking. www.againstsmoking.co.za
Available for interview:
Lorraine Govender, National Manager: Health Promotion for the Cancer Association of South Africa (CANSA)