Tobacco smoking reduces lung capacity and increases the risk and severity of respiratory infections: Dr Aparna Dhar

In India, nearly 45 per cent of all cancers among males, 17 per cent among females, and more than 80 per cent of oral cancers are directly attributable to tobacco use. Amidst the COVID-19 pandemic, tobacco has gained even more notoriety as studies have proved a direct link between frequent tobacco use and susceptibility to coronavirus infection complications. However, with timely diagnosis of any underlying disease and prompt lifestyle modifications, tobacco-users can fortify themselves and ensure better health in these troubling times, informs Dr Aparna Dhar, Lead Medical Geneticist and Genetic Counselor, CORE Diagnostics, to Tarannum Rana on the occasion of World No-Tobacco Day

In India, more than 80 per cent of oral cancers are directly attributable to tobacco use, and the substance is a leading cause of lung cancer as well. Tell us about the tests you conduct at CORE Diagnostics for tobacco-induced cancer.

India is, in present times, a country reeling under a huge burden of high mortality and morbidity linked with tobacco use and its addiction. Both smoking and chewing tobacco-use may cause many forms of cancers that may lead to early and painful death of the users. Oral cancer is the most common result of regular tobacco use, closely followed by lung cancer.

At CORE, we have a range of tests that are related to lung cancers- the pulmoCORE range. This range consists of tests that helps in diagnosis, classification, staging, treatment selection and risk stratification of lung cancers using varied technologies. Recently, we had a distribution agreement to expand the availability of DetermaRx to India — a stratification test that identifies patients at high risk for lung cancer recurrence, who may benefit from adjuvant chemotherapy post-surgery. Similarly, for oral cancers, albeit it is a smaller range in comparison to lung cancer, we offer a spectrum of immunohistochemistry markers and molecular profiling panels to help in diagnosis, classification, staging and treatment selection.

What is the number of average tests being conducted at CORE Diagnostics annually, with respect to tobacco-caused cancer? Has there been any increase in these numbers over the years?

Annually, we process close to 6,000 cases of lung cancer. Further, approximately, out of 70 per cent of the Indian cancers, 40 per cent are related to tobacco.

CORE Diagnostics has been approved by the ICMR to conduct COVID-19 tests. Which testing kits are you using, and what precautions have you taken to ensure the safety for your staff?

At CORE, we use RT-PCR testing that detects the presence of the virus in the earliest days of COVID-19 infection, and so far, remains the most reliable and most widely-used method. In comparison with other detection methods, RT-PCR has a lower possibility for errors or contamination as the whole procedure is run in a specialised BSL-2 lab by professionals trained to handle specimens such as those for COVID-19 testing.

I strongly believe that right now the role of organisations such as ours extends far beyond providing testing solutions for the pandemic.

To ensure safety, we have a separate designated area for COVID-19 testing with assured minimal entry. This area has separate spaces for the various steps of the test. There is negative pressure to ensure that air circulation is properly contained. We also use a biosafety cabinet for the processing. This whole setup is done in a BSL-2 lab.

Additionally, extensive training has been given to all our phlebotomists and lab teams on how to handle these samples using adequate protection and safety measures. Regular screening for signs and symptoms, fumigation, and cleaning of the lab after each run, placement of UV lamps, restriction of entry to minimum assigned people are some other steps that we are taking.

As the lockdown restrictions are being eased up, we will continue to follow the same norms even more meticulously, given that the number of employees as well as patients, will also relatively increase.

WHO experts, in a review of studies in April, reported that smokers are more likely to develop severe cases of COVID-19 compared to non-smokers. How can the early diagnosis of any underlying lung disease equip tobacco users to better deal with the pandemic? Additionally, have you seen an increase in tobacco users/smokers turning up for COVID-19 testing, compared to non-users?

According to a research on COVID-19 patients by the University of California San Francisco, risk of disease progression in smokers was nearly double than non-smokers. Tobacco smoking reduces lung capacity and increases the risk and severity of respiratory infections. As COVID-19 attacks the lungs, it could be harder for smokers to fight off the virus and they would be at a higher risk compared to non-smokers.

Early diagnosis of lung disease can help the patient in adopting a healthier lifestyle and seeking a doctor’s help as required. Quitting tobacco smoking can help in improving lungs and heart health. It can help in reducing the elevated heart rate, blood pressure and carbon-monoxide level in the bloodstream. Improvement in blood circulation and an increase in lung function directly boost a person’s immunity.

Currently, we do not have data of smokers and COVID-19 cases in our lab.