Release date: 2014-12-16
Under the guidance of environmental pollution factors, the incidence and mortality of lung cancer in China continued to rise. If effective control measures are not taken in time, it is estimated that by 2025, China's lung cancer patients will reach 1 million, becoming the world's largest lung cancer country.
Experts suggest that it is advisable to take multiple measures from the perspectives of environmental management, haze monitoring, pathological research, early diagnosis and health education to effectively reduce the risk of disease and improve the health of the people.
Lung cancer incidence continues to rise
Environmental pollution is an important cause
According to the 2012 China Cancer Registration Annual Report issued by the National Cancer Registry, data statistics and analysis of 85 million people in 24 provinces across the country show that there are 3.12 million new cases of tumors each year in China, with more than 2 million deaths, of which lung cancer has replaced liver cancer. , the top of the list of cancer morbidity and mortality. According to statistics from the National Health and Family Planning Commission, the incidence of lung cancer in China is growing at a rate of 26.9% per year. In the past few decades, the number of patients with lung cancer has doubled every 10 to 15 years. The results of the third survey of deaths in China also showed that lung cancer mortality has increased by 465% over the past 30 years, replacing liver cancer as the most common malignant tumor in China.
Studies have shown that smoking, environmental pollution, occupational exposure, chronic lung disease and genetic susceptibility are the main causes of lung cancer. Although smoking has always been considered as the first cause of lung cancer, many studies in recent years have shown that with the implementation of tobacco control measures, the rising incidence of lung cancer caused by smoking is clearly controlled, but lung cancer is positively related to environmental impact. The incidence rate has shown a rapid upward trend.
The Lung Cancer Center of the Second Affiliated Hospital of Zhejiang University School of Medicine recently counted all lung cancer patients admitted and diagnosed in the center from 2011 to 2013. The results showed that in the past 3 years, the number of lung cancer patients admitted to the hospital was 899, 988 and 999, respectively. Among them, the number of patients with squamous cell carcinoma was consistently maintained in more than 230 cases, and the proportion was decreasing year by year. "Small cell adenocarcinoma patients with direct effects on genetic mutations and environmental impacts are growing at a rate of 7 percentage points per year, accounting for 45.9%, 51.6%, and 58.3% of the number of lung cancer patients in the year." Wang Kai, executive deputy director of the Lung Cancer Center, and doctoral supervisor.
Previously, the Cancer Hospital of the Chinese Academy of Medical Sciences found that the pathological type of lung cancer showed significant changes in the case of more than 15,000 cases of lung cancer in the hospital over the past 10 years. Most of the previous lung cancers were squamous cell carcinomas, but now the proportion of adenocarcinomas Larger. Yang Gonghuan, a professor at the Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences who participated in the study, said: "Small particles of PM2.5 can enter the deep alveoli and have a causal relationship with the occurrence of adenocarcinoma."
Another indicator also confirms the impact of genetic mutations and the environment on the etiology of lung cancer: in lung cancer patients, the number of patients who do not smoke or are less exposed to second-hand smoke is increasing; at the same time, there is a small decline in smoking population. The number of female lung cancer patients has continued to increase, and the number of female smokers has not increased significantly.
In areas with high incidence of smog in Beijing and Tianjin, the incidence of lung cancer is significantly higher than the national average. Wang Ning, deputy director of the Beijing Cancer Prevention and Treatment Office, said that the incidence of lung cancer in Beijing increased from 39.56/100,000 in 2002 to 63.09/100,000 in 2011, which is far higher than the national average. The incidence of lung cancer in Tianjin is about 60/100,000. One-fifth of the new cancer patients are lung cancer patients, and they are obviously younger. The lung cancer mortality rate of males and females is the second in the country. One.
Multi-country research confirmed
PM2.5 is positively associated with lung cancer
The positive correlation between air pollution and increasingly severe haze weather and lung cancer has been confirmed by many experts and authoritative organizations at home and abroad.
The University of Ottawa in Canada conducted a 26-year follow-up study of 180,000 non-smokers in 50 states and Puerto Rico, and found a clear correlation between PM2.5 and lung cancer. The research data shows that air pollution is closely related to lung cancer production and mortality. The more serious the pollution, the more lung cancer, the higher the mortality rate, and vice versa. For every 10 micrograms per cubic meter of PM2.5 concentration, lung cancer mortality increases by 15%-27%, and the mortality rate of lung cancer in human lung disease itself is higher.
Studies suggest that tiny particles in the polluted air can damage the lungs through inflammation and damage DNA, which may be the direct cause of lung cancer death and death in non-smokers. The results of this study have now been published in international authoritative journals.
According to the latest data from the International Agency for Research on Cancer, 223,000 people worldwide died of lung cancer in 2010 were directly related to air pollution. To this end, the World Health Organization has listed “outdoor air pollution†as a class of carcinogens in 2013 and regards it as “the most widely spread carcinogen†to date.
As a fine particle of the “culprit†of smog weather, PM2.5 is mainly derived from automobile exhaust, exhaust gas from industrial production, and dust generated from construction sites and road traffic. Wang Kai said that PM2.5 can carry more than a dozen carcinogens, of which polycyclic aromatic hydrocarbons have a significant correlation with the prevalence of lung cancer.
Shi Yuankai, deputy dean of the Cancer Hospital of the Chinese Academy of Medical Sciences, also said that studies have shown that PM2.5 is directly inhaled into the lungs, which will directly lead to decreased alveolar elasticity, reduced function, and even induce pulmonary fibrosis, affecting alveolar ventilation. Over time, lung function declines and causes severe organic lesions and even lung cancer.
"The increase in PM2.5 is increasingly associated with lung cancer and directly increases the risk of lung cancer," said Zhong Nanshan, an academician of the Chinese Academy of Engineering. To this end, he has been paying attention to the issue of PM2.5 since the two sessions in 2012, and called for the monitoring of PM2.5 to be initiated as soon as possible nationwide.
Take more measures and take off
Low lung cancer risk
Experts said that in order to effectively control the incidence and mortality of lung cancer, and get rid of the "world's first lung cancer country", research, medical, environmental protection and other departments work together to break the existing stalemate and introduce effective measures has become a top priority.
After years of development, the problem of environmental pollution has become increasingly prominent, and it has become the highest livelihood issue among the people. The resulting genetic mutations and high cancer incidence are becoming more and more common. Zhang Xiaotiao, deputy dean of the Chinese Academy of Meteorological Sciences, and other experts have called for the state not only to carry out general surveys and monitoring of environmental pollution including the atmosphere, water, soil, etc., but also to introduce strong, long-term energy conservation and emission reduction. , shut down and transfer, recuperate and pollution remediation measures to reduce the negative impact of environmental pollution on public health from the source.
Song Weimin, director of the Department of Environmental Health, School of Public Health, Fudan University, suggested that large-scale lung cancer and pollution correlation surveys should be launched as soon as possible at the national level. He said that in addition to the sporadic investigations in various places, China has not yet conducted a large-scale census on the causes of lung cancer, especially air pollution and lung cancer. The lack of baseline data and correlation studies makes China lack the scientific basis and policy to reduce the risk of disease and control the rapid growth of lung cancer in China.
In addition, vigorous promotion of early detection of lung cancer is also positive for reducing lung cancer mortality. At present, 80% of lung cancer patients in China are in advanced stage, and their 5-year survival rate is only 13%. Bai Chunxue, a lung cancer expert and director of the Department of Respiratory Medicine of Zhongshan Hospital affiliated to Fudan University, said, “Even if active treatment measures are taken, The prognosis is also very poor.†While strengthening the support of the latest medical technology such as targeted therapy for lung cancer, combined with the three major medical insurance systems currently covered in China, lung cancer screening is conducted during the annual physical examination for early detection and early treatment. It is of positive significance to improve the life span and quality of life of patients. "Especially around the age of 40, it is necessary to start a comprehensive examination of the health of the lungs. Workers who have family inheritance and are often exposed to the outdoors need to check and check regularly." Ding Liren, deputy director of the Center for Lung Cancer Treatment and Treatment of the Second Hospital of Zhejiang Medical University, said.
Finally, the experts also called for the promotion of popular science propaganda through public health institutions and the media, and strive to change the public's low awareness rate of air pollution hazards and poor self-protection awareness. To prevent lung cancer, it is not only necessary to stay away from tobacco and avoid the environment of soot. It should also develop the habit of wearing masks in the severe climate of smog and other air pollution to reduce the inhalation of harmful substances.
Source: Economic Information
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