Cigarette smoking is certainly a major risk factor for lung cancer. But, it is not the only factor. Although black men smoke less than white men, they are almost 40 percent more likely to develop the disease and more likely to die from it. Even among non-smokers with lung cancer, the rate of death among African-Americans is much higher.

Without clear understanding as to why, lung cancer remains one of the top killers in the black community nationwide.

African-Americans are more affected by environmental causes of lung cancer. More live near highways or other high pollution areas which increases the risk. Black men are exposed more often to occupational hazards, like diesel fumes from transportation jobs. Air pollution from asbestos, second-hand smoke and radon inside homes are just as dangerous.

Radon — a gas that seeps out of soil into homes through the water supply and cracks in the foundation — is responsible for as many as 30,000 lung cancer deaths per year among both smokers and non-smokers. It is found to be more prevalent in minority communities, particularly low-income or government housing. One in every 15 American homes have detectable levels of radon.

HOW IT KILLS

Lung cancer develops when cells in the lung grow out of control and, as it continues to spread, makes breathing more difficult. Exposure to cigarette smoke and other pollutants damage the lung and increase the likelihood for those cells to change and grow abnormally. The more exposure, the greater the risk.

Early in the disease, a person with lung cancer may show no symptoms. As it worsens, the person may develop pain, shortness of breath, or coughing up blood. The cancer can also spread to other parts of the body.

Only 1 out of 7 Americans with lung cancer survives more than five years past diagnosis. Black men are dying at the highest rate of all groups, with black women dying at rates closer to that of white women. But, across all groups, the survival rate improves if lung cancer is found early.

HOW THINGS HAVE CHANGED

The incidence and rate of death have gone down for all men in recent years, yet black men still comprise most of the cases. The rates have held steady among U.S. women.

The CDC recently applauded the push for tobacco control the last 10 years. In 2000, no states had smoke-free laws. Now, 26 states do. Federal and state excise taxes on cigarettes have increased on average by $1.45 per pack since 2000 in an effort to deter smokers from purchasing cigarettes. The FDA’s ban on flavored cigarettes was aimed at preventing youth smoking.Potentially related to those changes, cigarette sales dropped by 22 percent from 2000 to 2005. What did not drop were sales of menthol flavored cigarettes — the type that 80 percent of Africans-Americans smoke. Some studies argue that menthols are more addictive than other types.

HOW WE CAN OVERCOME IT

Choosing not to smoke is the best way to prevent lung cancer. Even cutting down on the number of cigarettes per day can significantly decrease the risk.

There needs to be a stronger push for early detection and more aggressive treatment. African-Americans are typically diagnosed later in the disease, after it has already progressed. They also wait longer to begin treatment or refuse it all together.

Direct community outreach can focus not only on prevention, but also on educating people about lung cancer, discussing treatments and dispelling myths. Some African-Americans avoid lung cancer operations due to the false belief that exposing cancer to air during surgery will make it spread faster. In such cases, one myth can keep people from choosing potentially life-saving surgery.

More African-Americans are needed for medical research overall. Treatments that are known to work effectively on whites may or not work in all populations. Researchers recently found this true with one treatment for lung cancer — African-Americans in the study did not have the special characteristic that the drug targeted. Thus, they are less likely to benefit from that treatment.

Avoiding exposure to air pollution is just as important as not smoking. Radon test kits are readily available and easy to use.

Lastly, adding fruits and vegetables as part of a regular diet may help. A few studies show that among smokers or ex-smokers, eating large amounts of flavonoids — found in fruits, vegetables and teas — reduced the risk of lung cancer.

WHAT OTHERS ARE DOING TO KEEP US HEALTHY

Major health organizations announced this month that banning menthol cigarettes in particular could save 600,000 lives — one-third of whom are African-American. The FDA releases its decision mid-June.

Several states offer smoking cessation aids such as nicotine patches and nicotine gum at no cost. To access these resources or other support in quitting, call 1-800-QUITNOW or visit www.smokefree.gov.