In 2012, August 1 was declared World Lung Cancer Day—11 years later, its significance is as important as ever. Lung cancer is the second most diagnosed cancer and the leading cause of cancer-related death worldwide. In the United States, more people lose their lives to lung cancer than colon, prostate, and breast cancer combined. More than 238,000 people are diagnosed with lung cancer each year, and every day, more than 350 people die from the disease. There are two main types of lung cancer: non-small cell lung cancer, which accounts for 80% to 85% of lung cancer cases, and small cell lung cancer, which accounts for 10% to 15% of cases. Smoking cessation efforts coupled with advances in detection and treatment options have helped decrease the number of new lung cancer cases, however the disease still accounts for nearly 25% of all cancer-related deaths. But that was not always the case.
When lung cancer was first identified by doctors in the early 19th century, it was an extremely rare disease. However, by the end of the 20th century, it had become the leading cause of cancer-related deaths among men in more than 25 countries. This rapid increase caused scholars to hypothesize on the potential causes. For example, the 1930 edition of the Springer Handbook of Special Pathology handbook suggested that possible contributing factors for the rise in lung cancer incidents were: increased air pollution by gases and dusts, the asphalting of roads, the increase in automobile traffic, exposure to gas in World War I, the Spanish influenza pandemic of 1918, and an increase in the use of benzene and gasoline in work environments. Yet, the rate of lung cancer increased at the same pace in nations with fewer automobiles, industries, and paved roads as well as among workers who were not exposed to benzene or gasoline. And while attributing the rise of the disease to the Spanish flu may have seemed logical at the time (because World War I caused an unprecedented spread and made it one of the deadliest pandemics in human history), the rate of lung cancer had not increased following past influenza pandemics. Ultimately, it was another consequence of the war that was culpable.
Smoking cigarettes gained increased popularity around the world during World War I as cigarettes were included in the rations of soldiers. It is estimated that over 96% of British soldiers were regular smokers four months into the World War I. General John J. Pershing, a senior officer in the US army remarkably stated, “You ask me what we need to win this war. I answer tobacco as much as bullets. Tobacco is as indispensable as the daily ration; we must have thousands of tons without delay.”
His words were symbolic of the attitude towards cigarettes in the US, as the annual per capita use of cigarettes increased from 54 cigarettes in 1900 to 4,345 cigarettes in 1963. Although nearly 60 years have passed since the first report of the Surgeon General’s Advisory Committee on Smoking and Health shifted public perception on smoking by highlighting its correlation to lung cancer—that attitude has remained in some parts of the country. For example, at $0.17 per pack of 20 cigarettes, Missouri has the lowest cigarette tax in the United States—an amount considerably lower than the national average of $2.14. “Through the years, there has been multiple efforts to increase that tax rate, and they have just consistently failed,” said Ben Morris, MSED, RT(R)(T)(CT), assistant director at the Branson Cancer Center—a satellite location of CoxHealth, Hulston Cancer Center in Springfield, Missouri. “If Missouri got to just under the national average, which would be an astronomical increase, if we went from $0.17 and increased it a hundred-fold to $1.70, think about what that would do to our smoking rates in the community.”
Combatting generations of socialization takes time, and that is why recognizing World Lung Cancer Day remains important. Understanding this, ACCC continues to focus its efforts on developing comprehensive resources for multidisciplinary cancer care teams and patient advocates to better support lung cancer screening and treatment.
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