Smokers need regular lung cancer screenings, says doctor who wants to ban shisha

Smokers should be regularly screened for lung cancer as the condition remains the deadliest form of the disease in the UAE, according to a specialist doctor who wants a total ban on shisha pipes.

Lung cancer related deaths were discussed by medics at the European Society for Medical Oncology congress in Madrid.

Doctors there said global mortality rates were likely to rise by more than a million a year over the next 17 years, and regular screening of smokers was the most effective process of early detection.

Countries in the GCC will be subject to a 100 per cent tax on cigarettes from October, but doctors working in oncology in the UAE have said that won't go far enough to help reduce smoking related deaths.

“I’m not sure the 100 per cent tax in tobacco is enough to stop people smoking,” said Dr Falah Al Khatib, a consultant clinical oncologist at City Hospital, Dubai who quit smoking more than 30 years ago.

“If you really want to do something, the price needs to be much more, like in the UK and Australia.

“We also know shisha is a very bad habit, and it needs to change and be stopped completely. In the past smoking was very sociable.

“It was part of the hospitality to share cigarettes around, and part of being an adult.

“That should not be happening now with the knowledge we have.”

In 2015, there were about 1.7 million deaths related to lung cancer globally, of which 1.2 million were men.

The predicted number of annual global lung cancer deaths is expected to rise further from an anticipated 2 million in 2020, to 3 million by 2035 at current rates.

Health Authority Abu Dhabi health statistics from 2014 show lung, and other respiratory related cancers, caused 20.3 per cent of all cancer deaths in men.

Just 5.9 per cent of the total cancer deaths in women were a result of the same cancers.

“Incidence, the number of new cases, in the UAE is much like anywhere else in the world,” said Dr Al Khatib.

“This smoking population can be screened, it is not about going up and down the country screening everyone for cancer.

“What we can do is continue to educate people, doctors and health providers – and provide specialists of a high calibre and dedicated treatment with psychological support.”

Only about ten percent of all cancer patients in the UAE require terminal care, Dr Al Khatib said.

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In Europe, doctors said screening should be done on a national level with a central registry of use, so all radiology data can be interpreted to follow up on screenings, helping develop other international programmes.

Also speaking in Madrid, Kristiaan Nackaerts, a pulmonologist from Belgium specialising in respiratory oncology, was presenting the latest research into the effectiveness of regular screening of smokers.

“Lung cancer screening aims to reduce latent mortality and this should be done if possible with relatively limited harm by detecting these cancers in an earlier phase,” he said.

“Further refinements are needed to make it a cost effective process, and to reduce the radiation exposure if someone needs to be screened annually for ten or more years.

“These CT images can also be used to detect undiagnosed Chronic Obstructive Pulmonary Disease (COPD) and emphysema, for example, to increase the efficiency of screening, next to smoking cessation programmes which are also very important for those attending screenings and still smoking.”

The five day Esmo congress was attended by almost 24,000 doctors and academics, from 131 countries.

Policy, sustainability and the cost effectiveness of cancer treatments were widely in focus.

Biosimilars are medical products almost identical to an original product but manufactured by a different company and are new to oncology.

Doctors said they should be presented as a cheaper, valid option to facilitate access to treatment, and alleviate the strain on healthcare systems.

A record number of abstracts were submitted during the congress, with 1,736 selected for presentation.

Many focussed on the importance of cancer prevention and early diagnosis.

“Oncology is not only about medicines, as forty percent of cancers are preventable,” said Professor Josep Tabernero, Esmo president-elect.

“We should emphasise lifestyle changes that would reduce the incidence of cancer; stop smoking, reduce alcohol intake, having a balanced diet low in red meat, exercise, and avoid exposure to substances that have been shown to be carcinogenic.’’