Hematology and climate change....

more difficult to quantify, but with an increasingly ageing population, even a small increased risk would be worth mitigating because of its burden on human health.

Climate change is intensifying the spread and impact of neglected tropical diseases (NTDs) through multiple interconnected pathways. The recent UN Climate Change Conference (COP29), which took place in Baku, Azerbaijan on Nov 11–22, served as an opportunity to highlight these connections and call for integrated strategies to address both the root causes and immediate health impacts of NTDs in the context of climate change. However, the absence of a dedicated focus on NTDs remains a critical gap that must be addressed moving forward. A US$300 billion a year climate finance deal was struck at the conference, which will hopefully contribute to leveraging climate finance for health outcomes.

With only 25 years to go until we reach the 2050 Conference of the Parties goal of net-zero emissions, there is much work to be done to achieve this goal. Beyond the environmental impact on haematological diseases, there is also the environmental impact of haematology care. Work can be done to reduce the single-use plastics used in routine pathology testing. Life cycle assessments can be used to quantify the greenhouse gas emissions of various haematological procedures, such as blood transfusions. There will be many benefits to human health from policies that can mitigate the effects of climate change and reduce carbon emissions, and those of us in the field of haematology must do our part to contribute. Adapting health systems to address climate change is critical and necessary, and health-centred responses will be needed to secure a future in which world populations can thrive

Why Cancer Awareness important.

Cancer awareness plays a significant role in improving cancer prognosis by promoting early detection, timely treatment, and better disease management. Here are some key ways in which cancer awareness impacts prognosis:

1. Early Detection & Diagnosis

Awareness campaigns encourage regular screenings (e.g., mammograms, Pap smears, colonoscopies), leading to early-stage diagnosis.

Early-stage cancers are more treatable and have higher survival rates (e.g., breast cancer survival is >90% when detected early).

2. Prompt Medical Attention

Awareness helps individuals recognize symptoms (e.g., lumps, unusual bleeding, persistent cough) and seek medical care sooner.

Delayed diagnosis often results in advanced-stage cancer, reducing survival rates.

3. Improved Treatment Outcomes

Early diagnosis allows for less aggressive and more effective treatments.

Awareness leads to better adherence to treatment protocols, improving chances of remission and survival.

4. Prevention & Risk Reduction

Awareness about lifestyle factors (e.g., smoking, alcohol, diet, exercise) helps reduce cancer risk.

Vaccinations (e.g., HPV vaccine for cervical cancer) and preventive measures (e.g., sun protection for skin cancer) are more widely adopted.

5. Psychological & Social Benefits

Awareness reduces stigma, leading to better mental health support for patients.

It encourages participation in support groups and clinical trials, offering better treatment options.

Evidence-Based Impact

A study in The Lancet Oncology found that cancer survival rates improved significantly in countries with widespread awareness and screening programs.

WHO reports show that cervical cancer mortality drops by 50% in populations with strong HPV vaccination and screening programs.

Conclusion

Cancer awareness directly improves prognosis by facilitating early diagnosis, increasing treatment effectiveness, and encouraging preventive measures. Public health initiatives should continue promoting cancer education to enhance survival rates globally.

World Cancer Day .Role of Cancer Screening.

پھیپھڑوں کا کنسر۔۔۔۔

پھیپھڑوں کے کینسر کی اسکریننگ کی اہمیت پھیپھڑوں کا کینسر دنیا بھر میں کینسر سے ہونے والی اموات کی ایک بڑی وجہ ہے۔ جلد تشخیص کے ذریعے اس کا مؤثر علاج ممکن ہے، اور اسکریننگ اس میں بنیادی کردار ادا کرتی ہے۔ 1. جلد تشخیص اور بقا کی شرح میں اضافہ پھیپھڑوں کا کینسر ابتدائی مراحل میں زیادہ تر علامات ظاہر نہیں کرتا، جس کی وجہ سے اکثر دیر سے پتہ چلتا ہے۔ لو ڈوز کمپیوٹڈ ٹوموگرافی (LDCT) کے ذریعے اس کا جلد پتہ چلایا جا سکتا ہے۔ تحقیق (جیسے National Lung Screening Trial - NLST اور NELSON Trial) سے ثابت ہوا ہے کہ LDCT اسکریننگ پھیپھڑوں کے کینسر سے اموات کی شرح کو 20-24% تک کم کر سکتی ہے۔ 2. بہتر علاج اور کم اموات اگر پھیپھڑوں کا کینسر پہلے مرحلے (Stage I) میں تشخیص ہو جائے تو 5 سال تک بقا کی شرح 60-90% تک ہوتی ہے۔ لیکن اگر کینسر آخری مرحلے (Stage IV) میں پہنچ جائے تو یہ شرح 10% سے بھی کم رہ جاتی ہے۔ اسکریننگ کے ذریعے جلد علاج ممکن ہوتا ہے، جیسے سرجری، ریڈی ایشن، یا ہدفی تھراپی (targeted therapy)۔ 3. لاگت میں کمی اور مؤثر علاج آخری مراحل میں پہنچے ہوئے کینسر کا علاج زیادہ مہنگا اور پیچیدہ ہوتا ہے۔ جلد تشخیص سے کم خرچ میں بہتر علاج ممکن ہو جاتا ہے۔ 4. زیادہ خطرے والے افراد کی شناخت اسکریننگ خاص طور پر ان افراد کے لیے تجویز کی جاتی ہے جو: 50 سے 80 سال کی عمر کے ہوں (جیسا کہ USPSTF گائیڈ لائنز میں بتایا گیا ہے)۔ 30 سال تک سگریٹ نوشی کی عادت رکھتے ہوں (مثلاً روزانہ ایک پیکٹ 30 سال تک یا دو پیکٹ 15 سال تک)۔ ابھی بھی سگریٹ نوشی کر رہے ہوں یا پچھلے 15 سال میں چھوڑ چکے ہوں۔ 5. بیماری کے پھیلاؤ کو روکنا پھیپھڑوں کا کینسر تیزی سے دوسرے اعضاء (جیسے دماغ، جگر اور ہڈیوں) میں پھیل سکتا ہے۔

Free Lung Cancer Screening .,.

Importance of Screening in Lung Cancer

Lung cancer is one of the leading causes of cancer-related deaths worldwide, and early detection through screening significantly improves survival rates. Below are the key reasons why lung cancer screening is crucial:

1. Early Detection and Improved Survival Rates

Lung cancer is often asymptomatic in its early stages, leading to late diagnoses when treatment options are limited.

Screening, particularly with low-dose computed tomography (LDCT), helps detect lung cancer at an earlier, more treatable stage.

Studies, including the National Lung Screening Trial (NLST) and the NELSON trial, have shown that LDCT screening reduces lung cancer mortality by 20–24% in high-risk individuals.

2. Higher Treatment Success and Reduced Mortality

When lung cancer is diagnosed at Stage I, the 5-year survival rate is about 60–90%. In contrast, late-stage detection (Stage IV) has a survival rate of less than 10%.

Screening enables early intervention, increasing the chances of successful treatment through surgery, radiation, or targeted therapies.

3. Cost-Effectiveness of Preventive Screening

Treating advanced-stage lung cancer is significantly more expensive than treating early-stage disease.

Early detection reduces healthcare costs by allowing less invasive, more effective treatments.

4. Identification of High-Risk Individuals

Lung cancer screening is recommended primarily for:

Adults aged 50–80 years (as per USPSTF guidelines).

Those with a 30-pack-year smoking history (i.e., smoking one pack per day for 30 years or two packs per day for 15 years).

Current smokers or those who quit within the past 15 years.

5. Prevention of Advanced Disease and Metastasis

Lung cancer metastasizes quickly, often spreading to the brain, liver, or bones before symptoms appear.

Early detection through LDCT prevents disease progression and enhances the quality of life.

6. Public Health Impact

Large-scale screening programs can significantly reduce the lung cancer burden.

Countries like the U.S. and U.K. have implemented screening programs that have already demonstrated a reduction in lung cancer mortality.

Limitations and Risks of Screening

False Positives: Some LDCT scans may detect benign nodules, leading to unnecessary tests and anxiety.

Radiation Exposure: LDCT involves minimal radiation, but repeated scans pose a slight risk.

Overdiagnosis: Some slow-growing cancers may not have caused harm if left undetected, yet they may still be treated.

Conclusion

Lung cancer screening, particularly with low-dose CT scans, plays a crucial role in reducing mortality and improving patient outcomes. While not risk-free, the benefits far outweigh the drawbacks, making screening essential for high-risk individuals. Expanding awareness and access to lung cancer screening programs can save thousands of lives annually.

Free Lung Cancer Screening at AZIZIYAH Medical Centre Bathindi Jammu.

Lung cancer screening and early diagnosis are critical for improving outcomes. Here are some tips and guidelines:

1. Know the Risk Factors

Smoking: The most significant risk factor. Screening is highly recommended for current or former smokers.

Secondhand Smoke: Prolonged exposure increases risk.

Environmental Exposures: Radon gas, asbestos, and air pollution contribute to lung cancer risk.

Family History: A genetic predisposition can elevate risk.

2. Eligibility for Screening

Screening is typically recommended for:

Adults aged 50-80.

Those with a 20 pack-year smoking history (e.g., smoking one pack daily for 20 years).

Current smokers or those who quit within the last 15 years.

3. Screening Methods

Low-Dose Computed Tomography (LDCT):

Most effective for detecting lung cancer early.

Involves low radiation exposure.

Avoid chest X-rays for screening; they are less sensitive.

4. Early Symptoms to Watch For

Persistent cough (especially if it worsens).

Coughing up blood.

Shortness of breath or wheezing.

Chest pain that worsens with deep breathing or coughing.

Unexplained weight loss and fatigue.

5. Lifestyle Modifications for Prevention

Quit smoking immediately. Seek professional help or use nicotine replacement therapy if needed.

Test your home for radon.

Limit exposure to workplace carcinogens with protective gear.

Maintain a healthy diet and regular exercise routine.

6. Consult Your Doctor

Discuss your risk factors with a healthcare provider.

Ensure regular follow-ups if you are at high risk.

7. Be Proactive About Health

Encourage regular check-ups, especially if you have a history of smoking or other risk factors.

Promote awareness about lung cancer in your community.

Early detection saves lives. If you or someone you know meets the criteria for screening, consider scheduling an LDCT.

ASCO Lung Cancer Screening ...guidlines

Lung Cancer Screening Guidlines. ASCO.

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS literature commissioned for the US Preventive Services Task Force 2021 LCS recommendation update; a second systematic review of lung cancer risk associated with years since quitting smoking (YSQ); literature published since 2021; two Cancer Intervention and Surveillance Modeling Network-validated lung cancer models to assess the benefits and harms of screening; an epidemiologic and modeling analysis examining the effect of YSQ and aging on lung cancer risk; and an updated analysis of benefit-to-radiation-risk ratios from LCS and follow-up examinations. The GDG also examined disease burden data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. The GDG judged that the overall evidence was moderate and sufficient to support a strong recommendation for screening individuals who meet the eligibility criteria. LCS in men and women aged 50–80 years is associated with a reduction in lung cancer deaths across a range of study designs, and inferential evidence supports LCS for men and women older than 80 years who are in good health. The ACS recommends annual LCS with low-dose computed tomography for asymptomatic individuals aged 50–80 years who currently smoke or formerly smoked and have a ≥20 pack-year smoking history (strong recommendation, moderate quality of evidence). Before the decision is made to initiate LCS, individuals should engage in a shared decision-making discussion with a qualified health professional. For individuals who formerly smoked, the number of YSQ is not an eligibility criterion to begin or to stop screening. Individuals who currently smoke should receive counseling to quit and be connected to cessation resources. Individuals with comorbid conditions that substantially limit life expectancy should not be screened. These recommendations should be considered by health care providers and adults at high risk for lung cancer in discussions about LCS. If fully implemented, these recommendations have a high likelihood of significantly reducing death and suffering from lung cancer in the United States.

INTRODUCTION

In 1980, the American Cancer Society (ACS) withdrew a prior recommendation for regular lung cancer screening (LCS) with chest radiography (CXR) in persons who currently or formerly smoked because a series of randomized controlled trials (RCTs) conducted in the 1970s had not demonstrated convincing evidence that LCS saved lives.¹ Thirty-three years later, after publication of the National Lung Screening Trial (NLST) (ClinicalTrials.gov identifier NCT00047385) demonstrating that three rounds of annual LCS with low-dose computed tomography (LDCT) were associated with a 20% relative mortality reduction compared with annual LCS with CXR,² the ACS issued a recommendation for annual screening with LDCT in adults who met the eligibility requirement for the NLST (i.e., individuals aged 55–74 years with a 30 or greater pack-year history of smoking who currently smoke, or formerly smoked and had not exceeded 15 years since smoking cessation, and did not have life-limiting comorbidity).³ In this update of the 2013 LCS guideline, the ACS Guideline Development Group (GDG) addresses a broad spectrum of issues related to LCS, including the most recent evidence on the efficacy and effectiveness of LCS, the lung cancer risk in persons who formerly smoked and have exceeded 15 years since cessation, estimates of the benefits and harms of screening past age 80 years and screening in eligible adults with greater than 5 years of longevity, and updated benefit-to-radiation-risk ratios based on modern doses from ionizing radiation from screening and follow-up examinations. We also discuss the challenges of implementing LCS, enduring disparities in disease burden and screening rates, and the urgent need to significantly improve utilization and adherence to screening and follow-up testing among qualifying individuals.

In this update of LCS, the ACS recommends that individuals aged 50–80 years who currently smoke or who formerly smoked and are at high risk for lung cancer because of a 20 or greater pack-year history of cigarette smoking undergo annual LCS with LDCT (Tables 1 and 2). We also recommend against using any duration of years since quitting smoking (YSQ) as a criterion to begin or end LCS in individuals who formerly smoked and who meet age and pack-year eligibility criteria. Individuals who smoke should be advised to quit and offered evidence-based smoking-cessation interventions. Existing comorbid conditions that may limit life expectancy or the inability or unwillingness to undergo evaluation of positive screening findings or to undergo treatment are factors that should preclude referrals for screening. Because of these considerations, the risks associated with LCS, and the relative newness of LCS to the target population, potentially eligible individuals should undergo a process of shared decision-making (SDM) that includes a discussion about the purpose of LCS, the consensus among leading organizations on recommendations endorsing LCS; the screening process and the importance of regular screening; the benefits, limitations, and potential harms of screening; and consideration of patient values and preferences. We also discuss the challenges of implementing LCS, enduring disparities in disease burden and screening rates, and the urgent need to significantly improve utilization and adherence to screening and follow-up testing among qualifying individuals. This guideline for LCS is based on the underlying burden of disease, an assessment of the strength of evidence, the balance of benefits and harms, and consideration of patient values and preferences.

TABLE 1. American Cancer Society guideline for lung cancer screening, 2023.

These recommendations represent updated guidance from the American Cancer Society for asymptomatic persons who are at high risk of lung cancer based on cumulative exposure to tobacco by smoking.

Recommendation

The American Cancer Society recommends annual screening for lung cancer with low-dose computed tomography in asymptomatic individuals aged 50 to 80 years who currently smoke or formerly smoked and have a ≥20 pack-yeara smoking history (strong recommendation b; moderate quality evidence).