Early diagnosis of lung cancer prevention
I. Why is the incidence of lung cancer on the rise? Causal factors?
Lung cancer has become one of the major causes of cancer deaths in human beings, and in China, lung cancer is the number one cancer, accounting for 20% of cancer deaths, and the incidence and mortality rate are growing rapidly. The 5th International Conference on Lung Cancer predicts that lung cancer and AIDS are the two most serious diseases related to poor living habits that endanger human health at the beginning of this century. The incidence of lung cancer is also increasing in many regions of China, and it has taken the first place among malignant tumors in large cities.
The following risk factors are recognized as having a close relationship with lung cancer.
(a) Smoking The increase in the incidence of lung cancer is parallel to the increase in the sale of paper cigarettes. Paper cigarettes contain many carcinogenic substances such as benzo(a)pyrene. The smoking situation in China is very serious, with nearly 300 million people having the habit of smoking. The smoking rate of male adults in large cities is nearly 50% and that of women is nearly 5%. If necessary measures are not taken to control and discourage smoking, the incidence of lung cancer in China is bound to increase further in the next 10-30 years. Some Japanese scholars statistics, if the smoking index (smoking age × number of cigarettes per day) more than 600 people, the incidence of lung cancer is 72%, so the 3 “20” argument: that is, 20 cigarettes per day, 20 years of continuous smoking, the chance of lung cancer is 20 times more than non-smokers. Therefore, it is believed that men over 50 years of age with a smoking index of 600 or more are called a high-risk group.
(ii) Air pollution The incidence of lung cancer is higher in industrially developed countries, higher in urban than rural areas, and higher in factories and mines than in residential areas.
(iii) Occupational factors Long-term exposure to radioactive substances such as uranium, radium and their derivatives, carcinogenic hydrocarbons, heavy metals, coal tar, asphalt, petroleum, asbestos, mustard gas, etc. has been recognized. Poor ventilation in the kitchen and cooking habits are also associated with lung cancer.
(d) Chronic lung diseases such as tuberculosis, silicosis, pneumoconiosis, etc. can coexist with lung cancer.
(5) Intrinsic factors such as family genetics, lowered immune function, metabolic activities and endocrine dysfunction may also play a role in the development of lung cancer.
II. How to prevent?
From the perspective of risk factors, lung cancer can be prevented!
The main measures to prevent lung cancer are
(1) Non-smoking and smoking cessation
(2) Improve diet structure: eat more fruits and vegetables and less salted fish and meat
(3) Improve kitchen ventilation
(4) Exercise and exercise regularly
(5) Pay attention to the prevention and treatment of tuberculosis and COPD
(6) People over 40 years old and long-term smokers should pay attention to regular check-ups.
III. How to detect (diagnose) early?
The efficacy of lung cancer is related to the early and late diagnosis. The 5-year survival rate of early stage lung cancer patients can reach 60%-90% after surgery, while the overall 5-year survival rate of middle and late stage patients decreases from 40% to 5%. Therefore, to strive for “early detection, early diagnosis and early treatment” is an important measure to reduce the mortality rate of lung cancer.
(A) What are the common symptoms of lung cancer?
Most lung cancer patients have one or more of the following symptoms: persistent cough and cough with blood; shortness of breath and shortness of breath; discomfort when breathing; chest pain; pneumonia syndrome, such as fever and cough caused by airway mucosa; discomfort when swallowing; hoarseness; weight loss and poor appetite.
Any patient with the above symptoms should promptly go to the hospital for necessary tests, such as fiberoptic bronchoscopy, chest CT or MRI scan, and percutaneous pulmonary puncture. In addition, blood tests can be done, including carcinoembryonic antigen, salivary acid test, blood amylase, etc. Sometimes it is not clear at one time, and repeated tests are needed until it is clear. PET-CT is recommended for patients who have the condition to prevent early lung cancer from being missed.
(II) Commonly used examination methods
1.Chest X-ray examination
2.CT of chest, the ability to detect small nodules in the lung is 10 times that of X-ray chest film
3.PET-CT, the first one in Qingdao, was opened in Central Hospital on 2007-06-17.
4.MRI (magnetic resonance imaging)
5.Percutaneous fine needle aspiration biopsy (FNAB)
6.Sputum cytopathology examination
7.Bronchial endoscopy
8.Bone scan of the whole body, which can detect the presence of bone metastasis
9.Tumor marker examination (tissue, cell, blood or body fluid), serum cytokeratin 21-1 fragment (CYFRA 21-1); squamous cell carcinoma-associated antigen (SCC-Ag); neuron-specific enolase (NSE); tissue polypeptide antigen (TPA); gastrin-releasing peptide precursor (ProGRP); carcinoembryonic antigen (CEA)
10.Molecular pathology examination
Standardized, rational and individualized lung cancer treatment is the key to ensure the efficacy
The principle is that treatment should be standardized, reasonable and individualized. Surgery is the main treatment in early stage, and the combination of radiotherapy and chemotherapy is the main treatment in middle and late stage.