Epidemiology: Lung cancer

I. Introduction:

Uncontrollable cell division of mutated cells in the lungs will result in tumours, which
will lead to the occurrence of lung cancer (Aleskerov, 2021). These subtypes of lung tumours
are distinguished by distinct sets of driver mutations and phenotypic appearance, and they
frequently exhibit varying degrees of heterogeneity, aggression, and therapy resistance
(Ferone et al., 2022). When compared to other types of cancer, lung cancer is the highest
death rate cancer in Malaysia. As Dr. Cheng Pei Hua, my learning partnership, mentioned,
the lung cancer epidemic has reached epidemic proportions, with male patients
outnumbering female patients. Is gender, a factor closely related to lung cancer risk? What
are the potential solutions to this epidemiological problem using healthy lifestyles and
nanotechnologies?

Diagram 1: The pie

chart shows the
number of Malaysia’s
new cases of cancer
cases, in 2020. Lung
cancer is the most
after the breast cancer
and colorectum
cancer. (Global
Cancer Observatory,
2021)
 Diagram 2: The data shows the statistics of the Malaysia’s common cancer new cases and the
death cases in the year of 2020, the new cases for lung cancer is second highest, while the death
cases of the lung cancer patients is the highest amount.

II. Information about lung cancers (What lead the happen of lung cancer, why male
have higher lung cancer risk, and its latest global statistics)

The primary symptom of lung cancer is caused by uncontrolled cell mutation, tumour
formation, or respiratory system infection. However, the risk lung cancer has a close
relationship with the gender. The below data will use two countries as the sample, Malaysia
and China.
Diagram 3：Trachea, bronchus and lung: Comparison of age-standardised rate by year, major
ethnic group and sex, Malaysia

The age-standardised rate of lung cancer for both genders from 3 different ethnic group
shows the decreasing trend among year 2012-2016 compared to years of 2007-2011
(Azizah et al, 2019). The overall age-standardised incidence rate for lung cancer is 55 per
100000 between 2007-2011, but it decreases to 49.9. However, in data in the China is as
showed:
 Diagram 4 show the statistic of the age-standardised rate of lung cancer in China based on
gender and region. (Chen et al, 2015)

Form the data shown above, the age-standardised incidence rate for male lung cancer
patients is higher than the age-standardised incidence rate for female. Based on the data
obtained from both countries, a conclusion made is the male have the higher risk to get lung
cancer although the different ethnic group and living at different region. There are some
factors causing this kind of phenomenon are the jobs types and the percentage of male
smokers (Eldrige, 2021).

III. Factors causing the lung cancer

The primary symptom of lung cancer is caused by uncontrolled cell mutation, tumour
formation, or respiratory system infection. A tumour is formed when mutagens, such as
tobacco products, radioactive substances, x-rays, ultraviolet radiation, and a variety of
chemicals, which able to alter the DNA arrangement of the cells. Thus, mutagens inhaled
into the respiratory system cause lung cancer tumours (Raniszewska et al, 2021).

1. Smoker

As with smoking tobacco products, the combustion of the tobacco produces chemical
products such as 3,4-benzo-(α)-pyrene and tar, which will dry up the respiratory systems
and change the optimum condition for gaseous exchange, causing body cells undergoing
cell mutation to adapt to the condition, eventually leading to lung cancer (Parascandola &
Xiao, 2019). The chemical substances and their effects on the lungs are depicted in Diagram
5.
 Diagram 5: The summary of the chemical compound in the cigarette smoke and
the side-effects of these chemical compounds to human respiratory system. (Diagram
retrieved from Compound Interest, (2014))

Because cigarette smoke contains many chemicals which are carcinogens, inhalation
these chemicals leads higher risk of developing lung cancer. According to the World Health
Organization (2022), in 2020, 22.3% of the global population, 36.7% of all men, and 7.8% of
all women used tobacco. Thus, males constitute a larger proportion of global smokers, the
percentage of males developing lung cancer is higher than females.

2. Environment factor
Some lung cancer patients do not have smoking history, but the air we breathe
contains chemical products such as dust, carbon monoxide, and heavy metals, which have
the potential to cause cancer (Mudu et al., 2020). When these chemicals enter the human
respiratory system, they change the pH, humidity, and the organ functioning efficiency. As a
result, cell mutation may occur, lead the growth of cancer cells. The example of inhaling
polluted gases is similar to inhaling second-hand cigarettes smoke by passive smokers.
According to (CDCTobaccoFree, 2020), 2.5 million adults who are passive smokers died due
to inhale the second-hand smoke, since the 1964 Surgeon General’s Report.
Dr. Cheng also mentions that air pollution is one of the factors that contribute to the
occurrence of lung cancer. People who work or live in a highly polluted environment, such as
a heavy industrial area, are more likely to develop lung cancer because they inhale more
polluted air, which damages their lungs. Roadwork mechanics, for example, had a 2-3 times
higher risk of lung cancer than other jobs (Petit, 2019). According to NYCOSH. (2014), only
9% of construction workers are female, while 2.3% of female production workers, such as
labourers, electricians, and plumbers, are male. As more male construction workers are
exposed, the percentage of lung cancer risk occupied will rise linearly.

Effect of lung cancer to the patients

Because the lungs are the primary site for gaseous exchange during the
respiration process, once the cancer cell covers the lung, the gaseous exchange process is
rendered ineffective. Thus, lung cancer patients may experience shortness of breath if the
cancer spreads to block the major airways, as well as fluid accumulation around the lungs,
making it difficult for the affected lung to expand fully when inhaling (Litin et al., 2018).
Besides, Dr Cheng also share her experience about lung cancer issues cause the
high mortality rate with extremely poor prognosis, which significantly contributes to the
health-care and economic burden. We also have a high morbidity rate due to poor functional
status and significant disability, which adds to the social burden. Most patients may be
depressed because of their reduced life expectancy and impaired daily activities.

Possible solutions and measures to be taken to overcome the epidemiological problem

through a healthy lifestyle and nanotechnology.
Because manpower is the most important factor in a country's development, if it is
affected by the epidemiology of lung cancer, the country's development will be slowed. Thus,
the main cause of lung cancer is poor air quality, which is exacerbated by pollution. As a
result, communities should participate in some activities, such as a carpool campaign, which
could reduce the production of chemical gases that are harmful to the human respiratory
system. Furthermore, the best way to avoid getting lung cancer is to quit smoking. For
example, the teacher should explain the disadvantages of smoking to students in order to
instil the idea that smoking is bad in students' minds since childhood. Teachers should
support students to wear facial musk to filter the air inhaled.
Dr Cheng also mentioned, pulmonary delivery of drugs in forms of nano particles
help improve drug therapeutic effects while minimising systemic side effects as treatment is
targeted. Which mean nanotechnology also could be the effective solution for the lung cancer
as the Nano pills for the treatment have a small particle size, large specific surface area, and
good biocompatibility and degradability.

Conclusion
In conclusion, male have higher risk to get lung cancer. This epidemiology mainly
caused by the unhealthy habits, such as vaping, smoking or inhalation petroleum and the
quality of the air inhaled. Thus, the best solutions are quit smoking or try to maintain the
quality of the atmosphere air by some action such as carpool. While the Nano pills was the
final treatment to the lung cancer. Therefore, everyone has the responsibility to control this
lung cancer issues, to prevent the effects of lung cancer occurs on yourself or your family,
we must do something to practicing healthy lifestyle and stay away from lung cancer risk
factor.
(1099 words)
References
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Sukumaran, R., Balqis, B., Nadia, SMR., Sharifah, S, S, S, ., Rahayu, O., Nur Alham,
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Appendix
Learning partnership information:
Name : Dr Cheng Pei Hua
Occupation : Medical official
Workplace : Hospital Kuala Lumpur
Graduated institution : University of Aberdeen, Scotland
Details :
Dr Cheng is an experienced doctor, who have given me a lot of information and her opinion
about this topic, which about lung cancer issues based on her doctor career. The
communication has been done with the medium of WhatsApp and Google Form. In the
communication, she shared about the patients’ gender percentage and the application of the
nanotechnology in the medical field, especially in the cancer treatment.
The text history which I asked for the doctor agreement to be my learning partnership and

the discussion.

https://drive.google.com/file/d/1v5UEa4Ome9lLYdy3ulfQ6YSk7lBcp11E/view?usp=sharing.

The link is the google form respond from the Dr Cheng,