SALT LAKE CITY — Lung cancer is a growing concern in Utah, with one physician calling it "a silent epidemic."

"Lung cancer is the most lethal cancer malignant out there," said Dr. Thomas Varghese, director of thoracic surgery and chief value officer at Huntsman Cancer Institute. He said more people in the world die from lung cancer than from breast, prostate and colon cancers combined.

"In the United States, 433 people die each day from lung cancer, and yet, nobody really knows about it," Varghese said.

Part of the problem, Varghese said, is public misconception, as lung cancer is largely believed by the public to be caused by smoking, yet the disease is killing more and more people who have never smoked.

The American Cancer Society estimates that 154,000 people will die from lung cancer in 2018 and about 470 of those will be Utahns.

Utah's air quality, which can reach dangerous levels during inversion or wildfire seasons, is partly to blame. An April report from the American Lung Association revealed that people with lung cancer, asthma, cardiopulmonary obstructive disorder, cardiovascular disease and diabetes are at higher risk when air is more polluted in Utah.

Another report indicates that up to 3 percent of lung cancer cases in Utah can be attributed to poor air quality, or, more specifically, high levels of particulate matter that makes its way into critical tissue in the lungs.

The Utah Geological Society reports high levels of radon gas throughout much of the state, as well. Radon gas becomes a hazard when it concentrates indoors. It is believed to be a major cause of lung cancer in Utah, as the state has some of the highest radon levels in the U.S., Varghese said.

"We really need to highlight the prevalence of the disease," he said, adding that decreased exposure and increased detection is key.

Lung cancer is the second-most common cancer in men and women, and the leading cancer killer among women, according to the American Lung Association.

Varghese said concerning symptoms would include a cough that doesn't go away, sudden hoarseness and/or new onset of shortness of breath that cannot be explained by another illness. A low-dose computed tomography (CT) scan, available at Huntsman, can find if the lungs are affected. Beyond that, he said, there are a number of treatments that can be employed depending on the stage of the cancer.

Treatment varies from surgical intervention, both minimally invasive and more so, including robotic thoracic surgery, a new advance in technology that Varghese calls "the next leap forward." Huntsman is the first program in the Intermountain West to implement the robotic intervention.

"The biggest benefit is early recovery, shorter hospital length of stay and more quickly getting back to the things you enjoy doing," Varghese said.

Varghese encourages anyone with symptoms or a family history of the disease to be tested. He said treatment is promising, even in later stages, and many have dedicated their lives "to the pursuit of treating and eradicating the disease."

Lung cancer, he said, "is a deadly disease, and as with any other deadly disease, the efforts done to detect it at an earlier stage, you have better outcomes."