Izizathu Zokuyeka Ukubhema Ngeke Ukuqeda Ukufa Kwegciwane Lungula

by ULynne Eldridge, MD; Kubuyekeziwe ngo-Grant Hughes, MD

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Kungani Ukuyeka Ukubhema Ngeke Kuqede Ukufa Kwegciwane Lungula?

Kungani ukuyeka ukubhema ngeke kuqedwe ukufa komdlavuza wamaphaphu. UPeter Dazeley / Ukukhethwa Kwezithombe / I-Getty Izithombe

Iningi lethu liye lakhathazeka muva nje, izinhlangano ezihlose izinhloso zenze ukuyeka ukubhema kugxile kwenyanga yokuqwashisa umdlavuza wamaphaphu. Ngokuqinisekile, ukukhuthaza umphakathi ukuba ungalokothi uqale, futhi ukuyeka uma ubhema, kuyamangalisa. Futhi kubantu abanomdlavuza wamaphaphu, ukuyeka ukuhamba kungase kuthuthukise ukusinda. Noma kunjalo inyanga yokuqwashisa umdlavuza wamaphaphu kufanele ibe nokugxila okuhlukile.

Ukusabalalisa ulwazi ngokuyeka ukubhema kuncane kakhulu kulabo abaphila nomdlavuza wamaphaphu namuhla. Izinyanga ezinhlanu ngemva kokuthola ukuxilongwa komdlavuza wamaphaphu, amaphesenti angu-14 kuphela abantu abanesifo ababhemayo . Ukugxila ekubhemeni kufana nokwenza inyanga yokuqwashisa umdlavuza webele, konke mayelana nokwazisa abesifazane ukuthi kufanele babe nengane yabo yokuqala ngaphambi kweminyaka engama-30 (ukunciphisa ingozi yomdlavuza webele.) Inyanga yokuqwashisa kufanele ibe ngokusekela abantu abanesifo, hhayi mayelana nokuxoxa ngezimbangela.

Inyanga yokuqwashisa kufanele futhi ibe ngezimali zokucwaninga ukwelashwa okungcono. Labo ababhema esikhathini esidlule ngeke bazuze enkulumweni ngalokho abakwenzayo ngokungafani eminyakeni engu-20 edlule. Kunalokho, badinga ukwelashwa namuhla. Futhi ngenxa yokuthi ababhemayo abanaso lesi sifo - kungavamile ukucabangela umdlavuza wamaphaphu kungeke neze ababhemayo yiyona eyesi-6 eyimbangela yokufa komdlavuza e-US - lokhu kugxilisa inyanga eyenzelwe ukugubha izimpilo zabo ezingabalulekile.

Abanye abantu bangase bahlale besaba, kodwa funda ngezizathu ezengeziwe ukuthi kungani inyanga yokuqwashisa umdlavuza wamaphaphu akufanele ikwazi ukuyeka ukuyeka ukubhema njengokugxila okuyinhloko.

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Ubukhulu Babantu Abanomdlavuza We-Lung yi-Non-ACTIVE Smokers

Iningi labantu abanomdlavuza wamaphaphu abangabhemi. Istockphoto.com/Stock Photo © tai11

Umdlavuza we-Lung iyimbangela ehamba phambili yokufa komdlavuza kokubili amadoda nabesifazane e-United States. Umdlavuza we-Lung ubulala abesifazane abaningana kabili njengomdlavuza webele kanye namadoda amathathu njengomdlavuza wesibeletho. Ukubhema kuyimbangela eyinhloko yomdlavuza omncane wamangqamuzana omzimba ongasona omncane futhi unomthelela kumaphesenti angu-80 nangamaphesenti angama-90 okufa komdlavuza wamaphaphu kwabesifazane namadoda, ngokulandelana. Abesilisa ababhemayo banamathuba angama-23 okuthuthukisa umdlavuza wamaphaphu. Abesifazane ababhemayo banamathuba angaphezu kuka-13, uma kuqhathaniswa nabangabhemi. Phakathi kuka-2005 no-2010, ngokwesilinganiso abantu abangu-130 659 baseMelika (amadoda angama-74 300 nabesifazane abangu-56 359) bafa ngenxa yokubhema-umdlavuza wamaphaphu owodwa ngamunye. Ukuvezwa komusi womuntu oyisitokisi kubangela cishe abantu abangaba ngu-7 313 umdlavuza wamaphaphu emaphashini phakathi kwabangaboni ngaso sonke isikhathi ngonyaka. Abazimbizi banamathuba angama-20 kuya kwangu-30 amathuba okuba nomdlavuza wamaphaphu uma bebhekene nentuthu yomsizi ekhaya noma emsebenzini.

Kubalulekile ukwazi ukuthi izibalo zakamuva zibonisa ukuthi iningi labantu abangamaphesenti angama-60-abatholwa nomdlavuza wamaphaphu bangabhemi abange-ACTIVE . Lokhu kubandakanya abantu ababhema ngesikhathi esithile esidlule, kanye nalabo ababhemayo. E-United States, abesifazane abangamaphesenti angu-20 abanomdlavuza wamaphaphu ababhemayo, futhi lelo nani likhuphuka ngamaphesenti angu-50 abesifazane abanomdlavuza wamaphaphu emhlabeni wonke.

Amanani afana namaphesenti angu-20 angase abonakale amancane uze ubheke izibalo.

Futhi nakuba amaphesenti angaba ngu-30 kuya ku-40 abantu ababhema ngesikhathi sokuxilongwa, abantu abangamaphesenti angu-14 kuphela abanomdlavuza wamaphaphu baduma izinyanga ezingu-5 ngemva kokuxilongwa.

Ngamanye amazwi, iningi leziguli ezingabhemi ngesikhathi sokuxilongwa komdlavuza wamaphaphu zibhemayo odlule futhi sezivele ziyeka ukubhema ngaphambi kokutholakala. Ngenxa yalesi sizathu, abantu abaningi ababhekene nomdlavuza wamaphaphu namuhla ngeke bazuze ekuzwa ngezingozi zokubhema. Lokhu kugxila akusizi ngoba sebevele beyeka ukubhema, futhi kusebenza ekusakazeni inhlamba yomdlavuza wamaphaphu njengesifo somuntu obhemayo okwezinye izimo okungelona iqiniso. Ngeshwa, ngisho nalabo ababhemayo kungenzeka ukuthi babanjwe kulo mdlalo wokulahlwa. Unomdlavuza webele? Kuhle. Abantu bathanda uthando futhi babuze ukuthi bangakusiza kanjani. Unomdlavuza wamaphaphu? Amashiya aphakanyisiwe ahambisane nokuhlukahluka kombuzo othi, "Wawuze ude kuze kube nini?"

Kunezizathu eziningi zokuphila nomdlavuza wamaphaphu kungaba nzima kunokuhlala nomdlavuza webele . Akumelwe sengeze inhlamba yokubhema kule nkinga.

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Kunezinye Izimbangela Ze-Cancer Lung

Kunezimbangela eziningi zomdlavuza wamaphaphu. Istockphoto.com/Stock Photo © martin_33

Ngisho noma ugwayi ungakaze ukhulume emhlabeni, sisazoba nomdlavuza wamaphaphu. Yebo, ukubhema kuyimbangela ehamba phambili yomdlavuza wamaphaphu, kodwa kubangela ngaphandle kokubhema kubaluleke kakhulu. Nakuba inombolo ibonakala ibancanyana-amaphesenti angu-20 abesifazane abakha umdlavuza wamaphaphu abengeke ababhema-lokhu kuhumusha kulesihlanu kwabangu-71.660 ukufa komdlavuza wamaphaphu kwabesifazane kulindeleke ngo-2015.

Ukwehliswa kwe-Radon ekhaya kungumphumela wesibili oholela emdlalweni wamaphaphu kanye nenombolo eyodwa yomdlavuza wamaphaphu kwabangewona abokubhema. Abantu abangaba ngu-21 000 bafa ngomdlavuza wamaphaphu owenziwe i-radon ngonyaka, futhi lokhu kubangelwa ngokuphelele. Ukuthatha isitifiketi sokuhlola i-radon kusukela esitolo se-hardware se-10 bucks, futhi ukunciphisa i-radon kwenziwe uma ukuhlolwa kungavamile, yilokho okudingekayo.

Ukubeka lezi zinombolo ngendlela enengqondo kungasiza. Kulindeleke ukuthi abesifazane abangaba ngu-39 000 bafe ngenxa yomdlavuza webele ngo-2015. Uma ngabe sinesivivinyo esingu-$ 10 ukuze sihlole isici esiyingozi, futhi inqubo ebiza imali engaphansi kwenkulu engavimbela ngokuphelele isigamu sesifo somdlavuza webele, ucabanga ukuthi wezwa? Kungani umphakathi ongazi ngalokhu? Ibuyela emuva ekugxilweni kwalesi sihloko; sibeka ukugcizelela kokuqwashisa umdlavuza wamaphaphu ekubhemeni, futhi ngokwenza kanjalo, bashiya umphakathi ngomqondo wokuqinisekisa wamanga ukuthi konke kuhle uma ungabhemi.

Kunezinye izimbangela ezifanele ukubaluleka, kusukela ekungcoleni komoya ukungcoliswa komoya wangaphakathi, ukubhema umusi , kumathuba okusebenza emsebenzini . Ungacabangi ukuthi uphephile uma ungazange upheze. Funda ngezinye izimbangela zomdlavuza wamaphaphu kwabangewona abokubhema nokuthi yini ongayenza ukuze unciphise ingozi yakho.

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Abantu Abayeke Ukubhema Basengozini

Abantu basengozini yomdlavuza wamaphaphu ngisho nangemva kokuyeka ukubhema. Istockphoto.com/Stock Photo © imtmphoto

Ukuyeka ukubhema ngokuqinisekile kunciphisa ingozi yomdlavuza wamaphaphu, kodwa iningi, ingozi ethile ihlala njalo. Izinombolo kwisilayidi sokugcina zifakazela ngalokhu. Kukhona abanye ababhemayo abaqala ukubhema umdlavuza wamaphaphu unyaka ngamunye kunabokubhema .

Uma ubhema esikhathini esidlule, ungakhathazeki okwamanje. Ngemva kweminyaka eyishumi yokuyeka, ingozi yomdlavuza wamaphaphu iyancipha ngamaphesenti angu-30 kuya kuma-50%. Kunezinye izindlela zokunciphisa ingozi yokufa ngumdlavuza wamaphaphu.

Enye indlela i -CT emaphaphu yesifo somdlavuza ophansi . Ngesikhathi ukuhlolwa kunganciphisi ithuba lokuthi uzothola umdlavuza wamaphaphu, kwandisa amathuba ukuthi uma uthuthukisa umdlavuza wamaphaphu, uzotholakala ezinyathelweni zangaphambili, ezingaphili kakhulu zesifo. Kucatshangwa ukuthi ukuhlola abantu abasengozini kunganciphisa izinga lokufa emdlalweni wamaphaphu ngamaphesenti angu-20 e-United States. Ukucutshungulwa okwamanje kunconywa kubantu abaneminyaka engama-55 no-80, abanomlando wepakethe engu-30 wokubhema, futhi baqhubeka bebhema noma beyeka eminyakeni engu-15 edlule. Kwezinye izimo, ukuhlolwa kunganconywa kwabanye abantu ngokusekelwe ezicabangela zengozi yomdlavuza wamaphaphu .

Ngaphezu kwalokho, ucwaningo olubheke ekuzivocavoca kanye nomdlavuza wamaphaphu kanye nokudla nomdlavuza wamaphaphu kusikisela ukuthi kukhona ezinye izinto abantu abangenawo futhi abantu abanomdlavuza wamaphaphu abangayenza ukuze banciphise izingozi.

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Ama-Stigma Interferes Nge-diagnosis Early

I-stigma iphazamisa ukuxilongwa kokuqala komdlavuza wamaphaphu. Istockphoto.com/Stock Photo © lisafx

Ingxenye engiyithandayo yemicimbi yomdlavuza wamaphaphu engiya kuyo, yilapho abasindile bomdlavuza wamaphaphu babelana indaba yabo. Isikhathi esikhethekile, kepha oh sibuhlungu kakhulu. Isikhathi nesikhathi abantu bahlanganyela okwaba khona ekutholeni ukuxilongwa - kaningi uchungechunge lokuvakashelwa, nodokotela abaningana, esikhathini esiyizinyanga, ngesikhathi sokuthi baye bathola ukuthi banezinto ezivela ku-asthma kuya kwi-Lyme isifo.

Umdlavuza we-Lung ngezansi kwesikrini se-radon sabaningi bezempilo, ikakhulukazi umdlavuza wamaphaphu ekungabikho ababhemayo nomdlavuza wamaphaphu kubantu abadala . Ngenxa yalesi sizathu, abaningi bathola ukuthi umdlavuza wamaphaphu usuvele usakazeka, futhi ithuba lokuthola ukwelashwa ludlulile. Eqinisweni, abantu asebekhulile futhi abasoze baphumule cishe bayotholakala esiteshini esiphakeme sesifo.

Kuze kube yilapho sine thuluzi lokuhlola lokusabalalisa lomdlavuza wamaphaphu, kubalulekile kubachwepheshe bezempilo kanye neziguli ngokufanayo, ukuqaphela ukuthi konke okudingayo ukuthola umdlavuza wamaphaphu yimaphaphu. Izimpawu zomdlavuza wamaphaphu zingahluka kubantu abangabhemi kunabokubhema , kanti labo abesifo somdlavuza emaphaphu kwabesifazane bavame ukuhluka kunezimpawu zamadoda. Yiba ngummeli wakho. Uma unayo izimpawu ezingacacisiwe ngokwanele, cela incazelo engcono noma umbono wesibili. Uma sifuna ukuthola umdlavuza wamaphaphu ekuqaleni, sidinga ukuqeda inkolelo yokuthi umdlavuza wamaphaphu yisifo somuntu obhemayo. Leyo yingxenye yalokho inyanga yokuqwashisa ngomdlavuza wamaphaphu.

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I-Stigma Interferes NeCwaningo Lwezingculazi Ezintsha

I-Stigma iphazamisa ucwaningo lwezokwelapha ezintsha. Istockphoto.com/Stock Photo © AlexRaths

Inhlamba yomdlavuza wamaphaphu iholela ocwaningweni oluncane. Imali eyimfihlo yomdlavuza wesifu idlula umdlavuza wamaphaphu ngokude kakhulu, njengoba kuboniswa nguSusan G. Komen njengamagama asekhaya kanye namabhande ase pink abaluleke kakhulu. Bangaki abantu abangaqamba igama elingenalo inzuzo enkulu yomdlavuza wamaphaphu, futhi bangaki abantu ababazi ngisho nombala webhebhoni yomdlavuza wamaphaphu ?

Ukuxhasa ngemali yomphakathi kubuye kube ngemuva komdlavuza wamaphaphu, futhi lokhu kubalulekile ngoba imali isho amadola okushiwo ucwaningo. Ngo-2012, ukusetshenziselwa ukucwaninga kwe-federal kwanezela ku-$ 26,398 ngempilo ngayinye elahlekelwa umdlavuza webele, cishe u-$ 1,442 kuphela ngokulahlekelwa ngumdlavuza wamaphaphu. Ngivame ukuzibuza ukuthi izinga lokusinda lomdlavuza wamaphaphu laliyoba yini uma inani lemali kanye nocwaningo lwalusetshenzisiwe njengoba lube nomdlavuza webele.

Kungani imali ephansi kangaka, futhi kungani abacwaningi bengenakukwazi ukuzinikela emdlashini wamaphaphu? Inhlamba. Kukhona isitatimende esingabonakali, esingazwakalayo esithi, "Laba bantu babhema ngakho bafanelwe ukuba nomdlavuza." Akekho ofanelwe ukuba nomdlavuza wamaphaphu, kungakhathaliseki ukuthi akasoze aphuza noma umbhemi ohlala njalo. Ukwenza ukuyeka ukubhema kugxilwe ekuqwashweni komdlavuza wamaphaphu kwandisa kuphela inhlamba kanye negebe.

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I-Stigma Interferes Necwaningo Mayelana Nezizathu

Inhlamba yomdlavuza wamaphaphu iphazamisa ucwaningo ngezimbangela. Istockphoto.com/Stock Photo © tupungato

Ngenza ukuqhathaniswa ekuqaleni kokufa kwesifo somdlavuza wesifuba, okusho lokho kusuka kumdlavuza wamaphaphu obangelwa i-radon.

Lokho kungathathwa isinyathelo esengeziwe. Ngifunda izifundo zokufunda ngibheka izimbangela ezikhona zomdlavuza webele, kanye nokudla nezinye izinyathelo ezinganciphisa ingozi. Kuyinto engavamile lapho ngithola izifundo ezifanayo ngibheka umdlavuza wamaphaphu.

Yini ebangela umdlavuza wamaphaphu kwabangewona abhema? Kungani umdlavuza wamaphaphu ukhula ezincane, ungalokothi ubheme abesifazane?

Kudingeka sishintshe ubuso bomdlavuza wamaphaphu, ukuze siqale ukubuka izimpendulo ezikhona kule mibuzo.

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I-Cancer Lung yanda kwabasifazane abasha abangeke babheke

Umdlavuza wegciwane ukwanda kwabasha abasha ababhemayo. Istockphoto.com/Stock Photo © nicomenijes

Iningi lethu lifunde lezi zihloko eminyakeni yamuva. Umdlavuza wegciwane emadodeni manje wehla e-United States, kuyilapho lokho kwabesifazane kuye kwaqedwa. Kodwa kukhona iqembu elilodwa lapho umdlavuza wephaphu ukhula khona. Abesifazane abasha, ababheki nhlobo.

Laba besifazane kufanele babhekane nemibuzo ehlala njalo mayelana nesimo sabo sokubhema, noma okunye okuhlukile, "Ingabe abazali bakho babebhema lapho ukhula?"

Kungani singakwazi ukuphatha laba besifazane njengoba sibheka abesifazane ngomdlavuza webele ngo-Okthoba? Umdlavuza womlenze awuyona "isifo sobhemayo." Umuntu onomdlavuza wamaphaphu kungaba ngumama wakho noma indodakazi yakho noma udade wakho noma unyoko wakho.

Laba besifazane abasha bafanelwe ukwazi ukuthi abaxoshwa ngenxa yokugula kwesifo, kanti ngesikhathi esifanayo bebhekana nokuhlambalaza.

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Ukugxila kwenyanga yokuqwashisa umdlavuza we-Lung

Kuhle. Ngakho ukuyeka ukubhema akufanele kube yindlela kuphela yokugxila kwenyanga yokuqwashisa umdlavuza wamaphaphu. Yini okufanele ibe phakathi nendawo yokuqwashisa?

Inombolo eyodwa kufanele ixhaswe. Wonke umuntu oyedwa onomdlavuza wamaphaphu - kungakhathaliseki ukuthi umlando wokubhema - ufanelwe uthando lwethu, ububele, nokunakekelwa okungcono kunokwenzeka. Cabanga ngendlela abesifazane abaphathwa ngayo ngesikhathi sokuqwashisa umdlavuza webele, ukuthi bagubha kanjani, ukuthi bakhunjuzwa kanjani ukuthi ucwaningo lwenziwe ukwenza umehluko. Uma nje ungazi ukuthi ungathini, hlola la macebiso ezintweni ongazisho kumuntu onomdlavuza wamaphaphu . Ungayiphatha kanjani umngane wakho noma omthandayo ngomdlavuza wamaphaphu ngokuhlukile, uma enomdlavuza webele?

Inombolo ezimbili kufanele ibe mayelana nokuqwashisa. Ukuyeka ukubhema njengoba lokhu kwenziwa yonke indawo unyaka wonke. Esikhundleni sokuqaphela ukuthi umdlavuza wamaphaphu ukhona kubantu abangabhemi futhi ukwazi ulwazi izimpawu zakudala kungenza umehluko. Labo abasaqala ukubhema kufanele babe nethuba lokufunda mayelana nokukhetha kokuhlola.

Futhi njengoba nje inyanga yokuqwashisa umdlavuza webele iphakamisa izimali zocwaningo, inyanga yokuqwashisa umdlavuza wamaphaphu kufanele futhi ibe yisikhathi sokufundisa nokukhuthaza labo abanomdlavuza wamaphaphu mayelana nentuthuko entsha, ngenkathi behlinzeka ngezimali ukuze bathuthuke phambili.

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Izwi Mayelana Nokubhema Nengculaza Yamangqamuzana

Ukukhuluma ngokuhlukanisa inyanga yokuqwashisa umdlavuza wamaphaphu ekubhemeni akufanele ukugwema ukubhema njengimbangela yomdlavuza wamaphaphu. Ikona.

Kubantu abambalwa abaphila nomdlavuza wamaphaphu abhema, ukuyeka ukubaluleke kakhulu, futhi kungenzeka ukuthi into ebaluleke kakhulu umuntu angayenza ukuze kuthuthukiswe ukusinda. Hlola lezi zizathu eziyishumi zokuyeka ukubhema ngemuva kokuxilongwa komdlavuza . Ukuyeka ukubhema ngemuva kokuxilongwa komdlavuza wamaphaphu kuthuthukisa impendulo yokwelashwa komdlavuza, kuthuthukisa ikhwalithi yokuphila, futhi kuthuthukise ukusinda.

Kulabo abangenayo umdlavuza wamaphaphu, ukuyeka ukuphela kunganciphisi ingozi yomdlavuza wamaphaphu, kodwa kuthuthukisa ukusinda ngezinye izindlela. Ngaphezu komdlavuza wamaphaphu, kunezinhlobo eziningi zegciwane ezihlobene nokubhema , nezinye izimo eziningi zezokwelapha ezihlobene nokubhema.

Ibhulogi Lencwadi Yokuyeka Ukubhema kuyisisetshenziswa samahhala sokusiza ukuqoqa amathuluzi okudingayo ukuze uphumelele ngokuyeka umkhuba.

Kodwa khumbula ukuthi lezi zeluleko zokubhema nomdlavuza zafakwa ekugcineni ngesizathu. Zisebenza kuphela kubantu abambalwa abaphila nomdlavuza wamaphaphu namuhla.

Imithombo:

_{Amato, D. et al.} _{Ukuyeka Ukubhema Kungase Kwithuthukise Ukusinda Kwengculaza Yengculaza.} _{I-Journal ye-Thoracic Oncology .} _{2015. 10 (7): 1014-9.}

_{I-American Cancer Society.} _{Amaqiniso Nama-Cancer 2015. Ukutholakala ngo-06/08/15.} _{http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf}

_{I-American Lung Association.} _{I-Cancer Lung.} _{Ifinyelele ngo-11/27/15.} _{http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/}

_{I-American Society of Clinical Oncology.} _{Cancer.net Ukusebenzisa Ugwayi Ngesikhathi Ukwelashwa Kwemdlavuza.} _04/2012. _{http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/tobacco-use/tobacco-use-during-cancer-reatment}

_{Amato, D. et al.} _{Ukuyeka Ukubhema Kungase Kwithuthukise Ukusinda Kwengculaza Yengculaza.} _{I-Journal ye-Thoracic Oncology .} _{2015. 10 (7): 1014-9.}

_{I-Howlader, N., Noone, A., Krapcho, M., Garshell, J., Miller, D., Altekruse, S., Kosary, C., Yu, M., Ruhl, J., Tatalovich, Z., UMariotto, A., Lewis, D., Chen, H., Feuer, E., no-A. Cronin (eds).} _{I-SEER Review Statistics Statistics, 1975-2012, iNational Cancer Institute.} _{I-Bethesda, MD, esekelwe ukuthunyelwa kwedatha kaNovemba 2014, ithunyelwe kwiwebhusayithi ye-SEER, ngo-Ephreli 2015. http://seer.cancer.gov/csr/1975_2012/}

_{I-National Cancer Institute.} _{Izibalo zomdlavuza.} _{Kubuyekezwe 03/14/16.} _{http://www.cancer.gov/about-cancer/what-is-cancer/statistics}

_{I-National Cancer Institute.} _{I-Lung Cancer Prevention (PDQ).} _{Kubuyekezwe 05/12/15.} _{http://www.cancer.gov/types/lung/patient/lung-prevention-pdq#section/_12}

_{I-National Cancer Institute.} _{Ukubhema kuCancer Care-For Health Care Professionals.} _{Kufinyelelwe ngo-08/01/15.} _{http://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/smoking-cessation-hp-pdq#section/_1}

_{Parsons, A. et al.} _{Umthelela wokuyeka ukubhema ngemuva kokuxilongwa kwesifo somdlavuza wamaphaphu esandulela isandulela-ngculazi ekuhloliseni: ukubuyekezwa okuhlelekile kwezifundo zokuhlola nokuhlolwa kwe-meta.} _{I-British Medical Journal BMJ2010: 340: b5569.} _{Ishicilelwe ku-intanethi 21 Januwari 2010.}

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