DNP 825 Population Health Part I

Sample Answer

Population Health

Lung cancer is one of the most common cancers worldwide (Thai et al., 2021). Cigarette smoking has been identified as a major risk factor for lung cancer (Tindle et al., 2018).

The purpose of this paper is to highlight lung cancer prevalence in smokers, describe disparities in at-risk individuals, define evidence-based interventions that have been aimed to improve health outcomes in at-risk individuals and elaborate on the sources of health information available for at-risk individuals.

Lung Cancer in Cigarette Smokers

Lung cancer is a major cause of mortality worldwide. It can be classified as adenocarcinomas, squamous cell carcinomas, mixed carcinomas, neuroendocrine carcinoma, large cell carcinoma and other unusual morphological variants.

The incidence of lung cancer in women has shown a steady increase while in males there is a steady decrease. More than 50% of individuals with lung cancer at diagnosis usually have advanced metastatic disease (Kumar et al., 2018). Adenocarcinoma is the commonest while small-cell and squamous-cell carcinomas have a strong correlation with cigarette smoking.

Cigarette smokers are at an increased risk of lung cancer due to the carcinogens present. Cigarette smoking has been attributed to 90% of lung cancers and this includes individuals who ceased smoking. Cigarette smokers are 60 times more likely to develop lung cancer than non-smokers (Kumar et al., 2018). Other carcinogens may be implicated in lung cancer and these include asbestos, nickel, arsenic, uranium and chromium.

Environmental carcinogens may lead to lung cancer in non-smokers and can also act as a predisposing factor for lung cancers in cigarette smokers (Zhu et al., 2020). Passive smokers are also at risk of developing lung cancer.

Prevalence Rates of Lung Cancer
The prevalence of lung cancer in Pennsylvania varies by state. The counties in Pennsylvania can be clustered into 5 clusters whereby cluster 1 has the highest incidences and prevalence while cluster 5 has the lowest incidences and prevalence (Camiña et al., 2022).

The metropolitan areas of Pennsylvania have higher lung cancer incidence rates. Cluster 1 counties include Philadelphia, Montgomery and Delaware counties. Cluster 5 counties include York, Cumberland and Dauphin counties.

The prevalence of lung cancer in cigarette smokers in Philadelphia is higher than the prevalence of lung cancer in cigarette smokers in Dauphin County (Zhu et al., 2020). The national average of lung cancer incidence rates is lower than the incidence rates for lung cancer in Pennsylvania.

Social Determinants that Lead to Disparities and Health Outcomes

The areas in Philadelphia with a high prevalence and incidence of lung cancer among cigarette smokers have been densely populated. The impacts of environmental pollution therefore can affect large populations. These areas have also been shown to have high poverty rates.

This may deny access to screening and preventive services therefore at-risk individuals may only seek care when they are at advanced stages with poor prognosis (Zhu et al., 2020). Moreover, the level of education in such areas is low. Individuals may be unaware of the health impacts of cigarette smoking and therefore they may not have access to health promotion information and preventive strategies.

They may therefore be unaware that cigarette smoking and other air pollutants are risk factors for lung cancer. The unemployment rates in such areas are also high (Zhu et al., 2020). This may deny access to health care and preventive programs. Air pollution has been identified as a group 1 carcinogen. Factories are sources of air pollution. Moreover, there is occupational exposure to various carcinogens within these factories (Camiña et al., 2022).

These can predispose cigarette smokers to lung cancer. Carcinogens and cigarette smoking may be synergistic in lung cancer development. An example is a synergistic relationship between asbestos and cigarette smoking. Cigarette smokers exposed to asbestos have a 55-fold increased risk of developing lung cancer while non-smokers exposed to asbestos have a 5-fold risk of developing lung cancer (Kumar et al., 2018). Cigarette smokers may therefore have many disparities.

Evidence-Based Interventions for Cigarette Smokers

Cigarette smokers have been introduced to cigarette cessation programs to help addicts quit. Awareness has also been created of the dangers of cigarette smoking (Coughlin et al., 2020). This has included providing warnings on cigarette packets, public campaigns against cigarette smoking and media education programs.

Additionally, screening programs for cigarette smokers have been introduced to screen for lung cancers and offer timely management (Akanbi et al., 2019). Factories have also been encouraged to use renewable sources of energy and avoid toxic raw materials as a measure to curb air pollution. Incentives have been provided to protect factory workers from occupational exposure to carcinogens.

The government has also raised taxes on tobacco products and imposition of ‘no smoking’ policies as a means of reducing cigarette smoking (Hersi et al., 2019). Bans have also been imposed on advertisements and promotions that encourage cigarette smoking. These interventions have been effective as they have been able to reduce the rate of cigarette consumption.

Early stages of lung cancers have also been identified in cigarette smokers and appropriate treatments have been administered (Coughlin et al., 2020). The number of addicts in cessation programs has also increased. A lot still needs to be done to reduce the proportion of cigarette smokers but these incentives have been shown to work.

Availability of Consumer Health Information

Information about lung cancer, its risks and prevention are readily available from health information websites, health articles and health books (Demner-Fushman et al., 2019). Cigarette smokers can access this information and this can guide their behavior and provide them with relevant information.

They may also find healthcare options for their illnesses. They may find health facilities and rehabilitation centers that can help them with their addiction and treat any causes of morbidity. Moreover, they may find published research articles that relate cigarette smoking and lung cancer or other cancers and this may motivate them to quit. Cigarette smokers may also find health promotional information that may improve their health.

Conclusion

Lung cancer is a common cause of morbidity and mortality in both men and women. The risk factors include cigarette smoking and other environmental carcinogens such as air pollution and occupational exposure to nickel, chromium and asbestos. Cigarette smoking is a proven and major risk factor for lung cancer.

References

Akanbi, M. O., Carroll, A. J., Achenbach, C., O’Dwyer, L. C., Jordan, N., Hitsman, B., Bilaver, L. A., McHugh, M. C., & Murphy, R. (2019). The efficacy of smoking cessation interventions in low‐ and middle‐income countries a systematic review and meta‐analysis. Addiction, 114(4), 620–635. https //doi.org/10.1111/add.14518
Camiña, N., McWilliams, T. L., McKeon, T. P., Penning, T. M., & Hwang, W.-T. (2022). Identification of spatio-temporal clusters of lung cancer cases in Pennsylvania, USA 2010–2017. BMC Cancer, 22, 555. https //doi.org/10.1186/s12885-022-09652-8
Coughlin, S. S., Vernon, M., Majeed, B., Clary, C., Moore, J., Islam, K. M., & Tingen, M. S. (2020). Tobacco Cessation, Rural Residence, and Lung Cancer. Journal of Environment and Health Sciences, 6(1), 1–4. https //www.ncbi.nlm.nih.gov/pmc/articles/PMC7644114/
Demner-Fushman, D., Mrabet, Y., & Ben Abacha, A. (2019). Consumer health information and question answering helping consumers find answers to their health-related information needs. Journal of the American Medical Informatics Association. https //doi.org/10.1093/jamia/ocz152
Hersi, M., Traversy, G., Thombs, B. D., Beck, A., Skidmore, B., Groulx, S., Lang, E., Reynolds, D. L., Wilson, B., Bernstein, S. L., Selby, P., Johnson-Obaseki, S., Manuel, D., Pakhale, S., Presseau, J., Courage, S., Hutton, B., Shea, B. J., Welch, V., & Morrow, M. (2019). Effectiveness of stop smoking interventions among adults protocol for an overview of systematic reviews and an updated systematic review. Systematic Reviews, 8(28). https //doi.org/10.1186/s13643-018-0928-x
Kumar, V., Abbas, A. K., Aster, J. C., & Perkins, J. A. (2018). Robbins Basic Pathology (10th ed.). Philadelphia, Pennsylvania Elsevier.
Thai, A. A., Solomon, B. J., Sequist, L. V., Gainor, J. F., & Heist, R. S. (2021). Lung cancer. The Lancet, 398(10299), 535–554. https //doi.org/10.1016/S0140-6736(21)00312-3
Tindle, H. A., Stevenson Duncan, M., Greevy, R. A., Vasan, R. S., Kundu, S., Massion, P. P., & Freiberg, M. S. (2018). Lifetime Smoking History and Risk of Lung Cancer Results From the Framingham Heart Study. JNCI Journal of the National Cancer Institute, 110(11), 1201–1207. https //doi.org/10.1093/jnci/djy041
Zhu, Y., McKeon, T. P., Tam, V., Vachani, A., Penning, T. M., & Hwang, W.-T. (2020). Geographic Differences in Lung Cancer Incidence A Study of a Major Metropolitan Area within Southeastern Pennsylvania. International Journal of Environmental Research and Public Health, 17(24), 9498. https //doi.org/10.3390/ijerph17249498