Team Goemkarponn
PANAJI: The rising proportion of women among lung cancer patients in Goa has raised concern, with the National Organisation for Tobacco Eradication (NOTE) India calling for a dedicated epidemiological study to understand the reasons behind the changing trend.
According to NOTE India, Goa records approximately 120 to 150 new lung cancer cases every year. About a decade ago, around 90% of cases were reported among men and 10% among women. In recent years, however, the distribution has shifted substantially, with approximately 60% of cases among men and as many as 40% among women.
NOTE India President Dr Shekhar Salkar said the significant epidemiological shift cannot be ignored and warrants systematic investigation, particularly among women who have never actively smoked.
The organisation said the possible contribution of second-hand tobacco smoke, indoor air pollution, occupational exposure, environmental pollutants, biomass fuel exposure, radon and other risk factors needs to be examined rather than prematurely attributing the change to a single cause.
The concern comes against the backdrop of findings reported in a study published in The Lancet on the growing burden of disease and deaths associated with second-hand smoke. The study estimates that deaths linked to second-hand smoke in India increased from approximately 217,000 in 1990 to 325,600 in 2023. Among women, such deaths increased from about 113,400 to 156,900 during the same period.
The reported health risks associated with second-hand smoke include increased risks of chronic obstructive pulmonary disease, lung cancer, lower respiratory infections, ischaemic heart disease, breast cancer, asthma, stroke, type 2 diabetes and otitis media.
Dr Salkar said that being a non-smoker does not necessarily protect women from tobacco-related disease, as exposure to tobacco smoke at home, workplaces or other enclosed environments can have serious consequences. He stressed the need to determine how much of the changing lung cancer burden among women in Goa could potentially be linked to passive smoking and other preventable exposures.
NOTE India has proposed that a state-level study examine the incidence of lung cancer among women over the past decade or more, smoking status, exposure to second-hand smoke, indoor and outdoor air pollution, occupational and environmental exposures, and the age-wise and geographic distribution of cases.
The study should also examine the clinical and pathological characteristics of lung cancer among women and potential differences in risk factors between smokers and never-smokers.
Dr Salkar cautioned against jumping to conclusions about the cause of the increase but said the scale of the change in the male-to-female ratio warrants urgent investigation.
NOTE India has urged the Government of Goa, Directorate of Health Services, cancer registries, medical institutions and academic research organisations to undertake a comprehensive study of the changing lung cancer profile in the state, particularly the rising proportion of women affected.
The organisation also stressed that tobacco control should include protecting non-smokers from involuntary exposure to tobacco smoke, and called for stronger enforcement of existing smoke-free laws.
