Public Health Issue: Thoracic Disease Essay

Question:

Discuss about the Public Health Issue for Thoracic Disease.

Answer:

Introduction

Evidence-based research literature describes lung cancer in Australia as a major health issue that affects considerable number of smokers as well as non-smokers across the community environment (Pandeya, et al., 2015). The evidence-based findings state that 50% of the reported cases of cancer with the attribution of tobacco exposure correspond to pulmonary carcinomas across the Australian subcontinent (Pandeya, et al., 2015). Individuals affected by the prevalence of lung cancer patterns attribute to the subjects with family history of pneumonia, asbestosis, pneumonia and various carcinomatous conditions. Patients affected with the pattern of chronic cough and pulmonary dysfunction also remain predisposed to the development lung cancer across the Australian regions (Flynn, Peters, & Morgan, 2013). The findings by (Didkowska, Wojciechowska, Ma?„czuk, & ?Ѓobaszewski, 2016) indicate the pattern of elevated mortality among Australian women subjects under the influence of pulmonary carcinomatous conditions. However, global statistics reveal the influence of tobacco smoking on the pattern of lung cancer rates among men and women patients. The evidence-based findings by (Ridge, McErlean, & Ginsberg, 2013) describe the pattern of cigarette smoking as the biggest risk factor that predisposes the affected people towards the development of lung cancer across the community environment. Furthermore, people affected with asbestos exposure and influenced with passive smoke also experience the high risk of developing pulmonary carcinomatous conditions. The clinical literature reveals the high incidence of primary lung carcinoma among the aboriginal people affected with the poverty and psycho-socio-economic disadvantage (Gibberd, Supramaniam, Dillon, Armstrong, & O’Connell, 2016).

An increased percentage of mortalities from lung cancer observed among the aboriginal male as well as female population (Morrell, You, & Baker, 2012). However, this increased mortality rate attributes to the inaccessibility of aboriginal individuals in terms of attaining healthcare services for diagnosing and preventively treating the onset of lung cancer across the community environment. Although lung cancer symptoms remain unrecognized across the aboriginal population; however, the individuals of elevated socio-economic status appear to recognize the symptoms of haemoptysis and dyspnoea with their relevance to the pattern of lung cancer (Crane, et al., 2016). Furthermore, the exposure to radon beam, pre-existing pulmonary manifestations, age, gender and environmental hazards predominantly contribute to the development of lung cancer across the community environment in Australia (Groot & Munden, 2012). The research findings by (Whiteman, et al., 2015) indicate the influence of life style related factors of the prevalence of lung cancer patterns across the Australian region. The lifestyle attributions related to the physical inactivity, dietary inadequacies and sunlight exposure to some extent predispose the individuals towards the development of lung cancer; however, the factors like pharmacological interventions, age and air pollution also require consideration while investigating the possible causes of lung cancer progression across the community environment. The infectious conditions attributing to HPV and EBV might contribute to the progression of lung cancer across the community environment; however, the prospective organization of clinical trials necessarily warranted in the context of affirming their causality in relation to the establishment of lung cancer pattern among the predisposed individuals.

The Epidemiological Evidence

The statistics obtained from the observational studies and prescribed by the Australian government indicate the prevalence of lung cancer cases in Australia identified in terms of 12, 303 individuals affected by the onset of this disease in 2016 (Cancer-Australia, 2016). The statistics also reveal the elevated predisposition of male individuals in developing the stages of lung cancer, as compared to the female subjects in the Australian region. The prevalence of new cases of pulmonary carcinomas in 2016 attributed to 9.4%; however, the mortality percentage of lung cancer patients accounted for 18.8% as revealed by the statistical data. The lung cancer patients experience a low probability of survival (i.e. 15%) within a span of five years following the onset of lung cancer pattern (Cancer-Australia, 2016).

The incidence and prevalence of lung cancer pattern among the Australian individuals’ progresses with age and the resultant mortalities account for the lower survival rate of lung cancer patients across the community environment (Cancer-Australia, 2016). The retrospective analysis in the secondary article by (Islami, Torre, & Jemal, 2015) reveals the consistent decrease in the pattern of smoking among Australian individuals that reciprocally reduced the lung cancer mortalities among the male population. Contrarily, the lung cancer mortalities among the women individuals although have not reduced considerably with the decrease in the smoking habits; however, their stabilized pattern indicates the positive influence of tobacco control measures on the reduction in lung cancer cases across the predisposed population.

The qualitative research study by (Scott, et al., 2014) indicates the influence of absence of awareness about lung cancer manifestations on the prevalence and progression of lung cancer pattern among the linguistically diverse group of individuals residing across the Australian subcontinent. However, the findings of this research study fail to provide customized and tailor-made solutions to the focus groups in the context of challenging the establishment of lung cancer across the community environment.

The observational research study by (Marshall, et al., 2013) describes the effectiveness of undertaking diagnostic intervention attributing to low-dose CT in terms of proactively diagnosing the onset of lung cancer among the predisposed subjects across the Australian regions. The risk of the healthy individuals in terms of developing lung cancer calculated in accordance to their age, history of smoking and forced expiratory volume. The individuals at high risk of developing lung cancer disease required rigorous follow-ups for a tenure of five years for assessing their pulmonary health in concordance with the study conventions. The findings of this observational study claim to facilitate the configuration of healthcare policies in the context of reducing the risk of Australian masses towards the development of lung cancer. However, concrete strategies regarding the assessment of the influence of various health approaches and co-morbid states on the establishment of lung cancer not evidentially delineated through the observational findings of the research study.

The longitudinal cohort study by (Fasanelli, et al., 2015) evidentially indicates the 25% lifetime risk of the subjects affected with smoking habit in terms of their development of the pattern of lung cancer across the community environment. The findings of this research study reveal the influence of tobacco smoke on the methylation pattern of a particular set of genes that induce clonal differentiation of the hypomethylated cells leading to the onset of the carcinomatous processes across the pulmonary tissues. However, the study does not explore the influence of other environmental factors that might concomitantly influence the abnormal proliferation of lung cells among the predisposed individuals.

The literature review by (Yates, Schofield, Zhao, & Currow, 2013) discuses various palliative approaches warranted in managing the manifestations of pulmonary carcinoma among the affected patients. These palliative strategies assist the cancer patients of various age groups in terms of reducing the intensity of their symptoms attributing to depression, debility, pain and dyspnoea and help them in accomplishing their psychosocial requirements during the course of assistive interventions. However, the findings in the clinical literature do not provide insight regarding the influence of the palliative interventions in elevating the survival rate of the affected patients.

The quantitative review of the research literature presented by (Youlden, Cramb, & Baade, 2008) reveals the limited relative survival rate of lung cancer patients across the developed nations of the world, including Australia. The elderly population attribute to the highest number of lung cancer cases as compared to the young individuals, as revealed by the research findings. Australia reports a high frequency (i.e. 73.8%) of microscopically verified lung cancer cases among females as compared to the nations like Japan, Korea and UK. However, unspecified lung cancer cases among Australian females are reportedly highest (i.e. 28%) in comparison to the other developed countries of the world. Research findings explore the prospective burden of pulmonary cancer in relation to tobacco control strategies warranted for minimizing the risk of pulmonary complications among the predisposed individuals. However, the study does not take into account the biological and environmental factors that predominantly influence the onset and progression of lung cancer stages among the population of various age groups.

The literature review in the secondary article by (Daniels, et al., 2012) emphasizes the requirement of genome sequencing in the context of understanding the establishment of lung cancer patterns across the community environment. The techniques like polymerase chain reaction and the next generation sequencing assist the research community in evaluating the causative factors of abnormal differentiation of tissues leading to the development of metastatic pulmonary carcinomas. The genome sequencing methodology promises to explore the genetic contributors of lung cancer stages across the human generations and assists in evaluating the heterogeneity of pulmonary tumours among the affected patients. Therefore, with the advent of this latest technology, the scientists and physicians might attain a systematic approach in undertaking various prophylactic interventions for preventing the establishment of lung cancer patterns among the predisposed subjects. However, the effectiveness of genome sequencing in facilitating the epidemiological analysis of lung cancer in the presented scenario not well accorded by the qualitative study in (Daniels, et al., 2012).

The qualitative literature review by (Denton & Conron, 2016) indicates the requirement of administering the multidisciplinary interventions in the context of reducing the burden of lung cancer pattern across the Australian society. Undoubtedly, life expectancy and survival rate of lung cancer patients are limited and palliative care interventions do not promise to alleviate pulmonary manifestations in entirety. However, the timely delivery of diagnostic and treatment interventions and enhancement of quality of life of lung cancer patients hold the promise of effectively increasing the life span of the affected patients across the community environment. The evaluation of the extent of multidisciplinary medical interventions and their reciprocal effect on patient outcomes warrants the organization of prospective research studies in the context of configuring appropriate clinical approaches for challenging the progression of lung cancer stages among the affected patients.

Prospective Recommendations

The above-mentioned analysis of the evidence-based research literature reveals the epidemiological information and causative factors of lung cancer patterns. The analysis also emphasizes the requirement of configuring health care policies and interventions for effectively reducing the prevalence of lung cancer across the community environment in the Australian subcontinent. The prominent gap in the research literature attributes to the absence of definitive preventive as well as treatment approaches warranted for reducing the scope of lung cancer progression among the predisposed subjects. Randomized controlled trials, observational and cohort studies require concomitant organization by the research community in the context of exploring the definitive treatment strategies for lung cancer and precisely evaluating the onset and progression of this disease across the community environment. Research studies that require genome investigation of the cancer patients with the objective of identifying the tumor markers are highly warranted in the context of configuring target specific therapies for mitigating the abnormal proliferation of pulmonary cells and tissues among the lung cancer patients. Observational studies organized so far with the objective of evaluating the epidemiology of lung cancer could not effectively categorize the progression mechanism of lung cancer across the Australian regions. Therefore, genetic exploration of lung cancer mechanism through clinical studies requires execution in generating evidence regarding the healthcare strategies for assisting the patients affected with the pattern of lung cancer across the community environment.

Conclusion

Statistics of lung cancer indicate the high prevalence of lung cancer cases among male and female individuals across the Australian regions. The age standardized incidence rate of lung cancer cases and the limited life expectancy of the affected patients are the public health issues requiring constant attention by the research community as well as Australian government for stabilizing the quality of life of the patient – population and corresponding wellness outcomes. The geographical as well as environmental influence on the progression of lung cancer patterns requires consideration by the research professionals while evaluating the epidemiology and statistics of lung cancer across the community environment. The organization of prospective research studies in evaluating the influence of multidisciplinary medical interventions on the prognosis of lung cancer might prove beneficial while designing pharmacological as well as rehabilitative interventions in treating the manifestations of this life threatening disease. Furthermore, the influence of lung cancer risk factors attributing to smoking, air pollution, radiotherapy, family history of pulmonary carcinoma, COPD and pulmonary infections requires analysis through prospective clinical studies in the context of minimizing the risk of lung cancer establishment among the predisposed subjects.

References

Cancer-Australia. (2016, June 5). Australian Government Cancer Australia. Retrieved from

Crane, M., Scott, N., O'Hara, B. J., Aranda, S., Lafontaine, M., Stacey, I., . . . Currow, D. (2016). Knowledge of the signs and symptoms and risk factors of lung cancer in Australia: mixed methods study. BMC Public Health. doi:10.1186/s12889-016-3051-8

Daniels, M., Goh, F., Wright, C. M., Sriram, K. B., Relan, V., Clarke, B. E., . . . Fong, K. M. (2012). Whole genome sequencing for lung cancer. Journal of Thoracic Disease, 4(2), 155-163. doi:10.3978/j.issn.2072-1439.2012.02.01

Denton, E., & Conron, M. (2016). Improving outcomes in lung cancer: the value of the multidisciplinary health care team. Journal of Multidisciplinary Healthcare, 137-144. doi:10.2147/JMDH.S76762

Didkowska, J., Wojciechowska, U., Ma?„czuk, M., & ?Ѓobaszewski, J. (2016). Lung cancer epidemiology: contemporary and future challenges worldwide. Annals of Translational Medicine, 4(8). doi:10.21037/atm.2016.03.11

Fasanelli, F., Baglietto, L., Ponzi, E., Guida, F., Campanella, G., Johansson, M., . . . Vineisa, P. (2015). Hypomethylation of smoking-related genes is associated with future lung cancer in four prospective cohorts. Nature Communications. doi:10.1038/ncomms10192

Flynn, A. E., Peters, M. J., & Morgan, L. C. (2013). Attitudes towards Lung Cancer Screening in an Australian High-Risk Population. Lung Cancer International. doi:10.1155/2013/789057

Gibberd, A., Supramaniam, R., Dillon, A., Armstrong, B. K., & O’Connell, D. L. (2016). Lung cancer treatment and mortality for Aboriginal people in New South Wales, Australia: results from a population-based record linkage study and medical record audit. BMC Cancer. doi:10.1186/s12885-016-2322-1

Groot, P., & Munden, R. F. (2012). Lung cancer epidemiology, risk factors, and prevention. Radiologic Clinics of North America, 863-876.

Islami, F., Torre, L. A., & Jemal, A. (2015). Global trends of lung cancer mortality and smoking prevalence. Translational Lung Cancer Research, 4(4), 327-338. doi:10.3978/j.issn.2218-6751.2015.08.04

Marshall, H. M., Bowman, R. V., Crossin, J., Lau, M. A., Slaughter, R. E., Passmore, L. H., . . . Fong, K. M. (2013). Queensland Lung Cancer Screening Study: rationale, design and methods. Internal Medicine Journal, 174-182. doi:10.1111/j.1445-5994.2012.02789.x

Morrell, S., You, H., & Baker, D. (2012). Estimates of cancer incidence, mortality and survival in aboriginal people from NSW, Australia. BMC Cancer. doi:10.1186/1471-2407-12-168

Pandeya, N., Wilson, L. F., Bain, C. J., Martin, K. L., Webb, P. M., & Whiteman, D. C. (2015). Cancers in Australia in 2010 attributable to tobacco smoke. Australian and New Zealand Journal of Public Health, 39(5), 464-470. doi:10.1111/1753-6405.12446

Ridge, C. A., McErlean, A. M., & Ginsberg, M. S. (2013). Epidemiology of Lung Cancer. Seminars in Interventional Radiology, 30(2), 93-98. doi:10.1055/s-0033-1342949

Scott, N., Donato-Hunt, C., Crane, M., Lafontaine, M., Varlow, M., Seale, H., & Currow, D. (2014). Knowledge, attitudes and beliefs about lung cancer in three culturally and linguistically diverse communities living in Australia: a qualitative study. Health Promotion Journal of Australia, 25(1), 46-51. doi:10.1071/HE13095

Whiteman, D. C., Webb, P. M., Green, A. C., Neale, R. E., Fritschi, L., Bain, C. J., . . . Carey, R. N. (2015). Cancers in Australia in 2010 attributable to modifiable factors: introduction and overview. Australian and New Zealand Journal of Public Health, 403-407. doi:10.1111/1753-6405.12468

Yates, P., Schofield, P., Zhao, I., & Currow, D. (2013). Supportive and palliative care for lung cancer patients. Journal of Thoracic Disease, S623–S628. doi:10.3978/j.issn.2072-1439.2013.10.05

Youlden, D. R., Cramb, S. M., & Baade, P. D. (2008). The International Epidemiology of Lung Cancer: Geographical Distribution and Secular Trends. Journal of Thoracic Oncology, 3(8), 819-831. doi:

How to cite this essay: