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{{Lung cancer}}
{{Lung cancer}}


{{CMG}}; '''Associate Editor(s)-In-Chief:''' Kim-Son H. Nguyen, M.D., M.P.A., Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA, {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[User:Michael Maddaleni|Michael Maddaleni, B.S.]]
{{CMG}}; {{AE}} {{KSH}} {{CZ}}; {{Rim}}; '''Assistant Editor(s)-In-Chief:''' [[User:Michael Maddaleni|Michael Maddaleni, B.S.]]


==Overview==
==Overview==
Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality with 1.35 million new cases per year and 1.18 million deaths. The highest rates are observed in Europe and North America.  The population segment most likely to develop lung cancer is those individuals over-fifty years of age who have a history of [[smoking]]. Although the rate of men dying from lung cancer is declining in western countries, it is actually increasing for women due to their increased rate of smoking. Among lifetime non-smokers, men have higher age-standardized lung cancer death rates than women. The expected number for new cases of [[lung cancer]] in the United States for 2014 is 224,210.<ref name="SiegelMa2014">{{cite journal|last1=Siegel|first1=Rebecca|last2=Ma|first2=Jiemin|last3=Zou|first3=Zhaohui|last4=Jemal|first4=Ahmedin|title=Cancer statistics, 2014|journal=CA: A Cancer Journal for Clinicians|volume=64|issue=1|year=2014|pages=9–29|issn=00079235|doi=10.3322/caac.21208}}</ref>
Lung cancer is the most common cause of [[cancer]]-associated [[mortality]] and the second most common type of [[cancer]] among both genders. Individuals > 50 years of age who have a history of [[smoking]] are at increased risk. Historically, the [[incidence]] of lung cancer is significantly higher among [[Male|males]] compared to [[Female|females]]. This increased ratio is thought to be attributed to the increased rates of [[smoking]] among [[Male|men]]. However, more [[Female|women]] are being [[Diagnosis|diagnosed]] with lung cancer due to the increased rate of [[smoking]] among [[Female|women]]. In 2014, the [[incidence]] of [[lung cancer]] in the United States was approximately 70 cases per 100,000.


==Prevalence==
==Epidemiology and Demographics==
In the United States, the age adjusted prevalence of cancer of the lungs and bronchus is 0.1004 % in 2011.
===Incidence===


===Prevalence by Cause===
*In 2014, the [[incidence]] of [[lung cancer]] in the US alone was approximately 70 cases per 100,000.<ref name="SiegelMa2014">{{cite journal|last1=Siegel|first1=Rebecca|last2=Ma|first2=Jiemin|last3=Zou|first3=Zhaohui|last4=Jemal|first4=Ahmedin|title=Cancer statistics, 2014|journal=CA: A Cancer Journal for Clinicians|volume=64|issue=1|year=2014|pages=9–29|issn=00079235|doi=10.3322/caac.21208}}</ref>
====Smoking====
*Being the most common cancer diagnosed worldwide, it accounted for 2.1 million new cases in 2018.<ref name=":0">{{Cite web|url=https://www.who.int/news-room/fact-sheets/detail/cancer|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
[[Tobacco smoking|Smoking]], particularly of [[cigarette]]s, is by far the main contributor to lung cancer. In the United States, smoking is estimated to account for 87% of lung cancer cases (90% in men and 85% in women).<ref name="Samet2">{{cite journal | last =Samet | first =JM | coauthors =Wiggins CL, Humble CG, Pathak DR | title =Cigarette smoking and lung cancer in New Mexico | journal =American Review of Respiratory Disease | volume =137 | issue =5 | pages =1110–1113 | date =May 1988 | pmid =3264122 }}</ref> It should also be noted that approximately 15 years after quitting smoking, the risk of lung cancer approaches that of a nonsmoker.
*In 2015, the US State Kentucky recorded the highest [[incidence rate]] in both men (105.6 per 100,000) and women (77.5 per 100,000) in the country.
*In 2015, the US State Utah recorded the lowest [[incidence rate]] in both men (29.6 per 100,000) and women (22.1 per 100,000) in the country.


By the year 2030, the [[World Health Organization]] (WHO) projects that [[tobacco]] related deaths will hit an annual death rate of 3 million people in industrialized countries and 7 million in developing countries<ref name="pmid18460664">{{cite journal |author=Kenfield SA, Stampfer MJ, Rosner BA, Colditz GA |title=Smoking and smoking cessation in relation to mortality in women |journal=[[JAMA : the Journal of the American Medical Association]] |volume=299 |issue=17 |pages=2037–47 |year=2008 |month=May |pmid=18460664 |pmc=2879642 |doi=10.1001/jama.299.17.2037 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18460664 |accessdate=2011-12-19}}</ref>.
===Prevalence===
*In the United States, the age-adjusted [[prevalence]] of [[cancer]] of the [[lungs]] and [[bronchus]] is estimated to be 100 per 100,000.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
*The [[prevalence]] of lung cancer significantly increases among [[Smoking|smokers]] and individuals with [[Chronic (medical)|chronic]] exposure to [[risk factors]] for lung cancer.


====Radon Gas====
===Mortality rate===
Radon gas is the cause of approximately 15,000 to 22,000 deaths per year or 12% of the total number of lung cancer deaths per year. Radon gas is the second major cause of lung cancer behind smoking.


Radon gas levels vary by locality and the composition of the underlying soil and rocks. For example, in areas such as Cornwall in the UK (which has granite as substrata), radon gas is a major problem, and buildings have to be force-ventilated with fans to lower radon gas concentrations. The [[United States Environmental Protection Agency]] (EPA) estimates that one in 15 homes in the U.S. has radon levels above the recommended guideline of 4 pico[[Curie]]s per liter (pCi/L).<ref name="EPA radon">{{cite web | last =EPA |authorlink =United States Environmental Protection Agency | title =Radiation information: radon | publisher =EPA | date =Oct 2006 |url =http://www.epa.gov/radiation/radionuclides/radon.htm | accessdate =2007-08-11 }}</ref> Iowa has the highest average radon concentration in the United States; studies performed there have demonstrated a 50% increased lung cancer risk with prolonged radon exposure above the EPA's action level of 4 pCi/L.<ref name="Field">{{cite journal | last =Field | first =RW | coauthors = Steck DJ, Smith BJ et al. | title =Residential radon gas exposure and lung cancer: the Iowa Radon Lung Cancer Study | journal =American Journal of Epidemiology | volume =151 | issue =11 | pages =1091–1102 | publisher =Oxford Journals | date =Jun 2000 | url =http://aje.oxfordjournals.org/cgi/reprint/151/11/1091  | pmid =10873134 | accessdate =2007-08-11 }}</ref><ref name="EPA Iowa">{{cite web | last =EPA | authorlink =United States Environmental Protection Agency | title =Iowa Radon Lung Cancer Study |publisher =EPA | date =Jun 2000 | url =http://www.epa.gov/radon/iowastudy.html | accessdate =2007-08-11 }}</ref>
* Being the most common [[cancer]] [[Diagnosis|diagnosed]] worldwide, lung cancer is responsible for 1.8 million deaths in 2018.<ref name=":0" />


====Asbestos====
* The [[American Cancer Society]] estimates that approximately 142,670 individuals will die of lung cancer in the US in the year 2019.<ref>{{Cite web|url=https://www.cancer.org|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
Asbestos related lung cancer is rarer than radon gas or smoking. It accounts for approximately 3,400 to 8,500 cases per year in the United States. In the UK, asbestos accounts for 2–3% of male lung cancer deaths.<ref name="Darnton">{{cite journal | last=Darnton | first=AJ | coauthors =McElvenny DM, Hodgson JT | title =Estimating the number of asbestos-related lung cancer deaths in Great Britain from 1980 to 2000 | journal=Annals of Occupational Hygiene | volume=50 | issue=1 | pages=29–38 | date=Jan 2006 |url=http://annhyg.oxfordjournals.org/cgi/content/full/50/1/29 | pmid=16126764 | accessdate=2007-09-07 }}</ref>
* The [[mortality rate]] for men is 46.7 per 100,000 individuals.<ref name=":1">{{Cite web|url=https://www.lung.org|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2">{{Cite web|url=https://www.cdc.gov/nchs/data_access/cmf.htm|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* The [[mortality rate]] for women is 31.9 per 100,000 individuals.<ref name=":1" /><ref name=":2" />


==Incidence==
===Age===


* The delay-adjusted incidence of invasive cancer of the lungs and bronchus in 2011 was estimated to be 56.64 per 100,000 persons in the United States.
* Lung cancer is more common in older [[Adult|adults]]. It is rare in people under age of 45 years.
* In 2011, the age-adjusted incidence of invasive cancer of the lungs and bronchus was 55.50 per 100,000 persons in the United States.
* While the overall age adjusted [[incidence]] of cancer of the [[lungs]] and [[bronchus]] in the United States between 2007 and 2011 is 60 per 100,000, the age-adjusted [[incidence]] of lung cancer by age category is:<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>
**'''Under 65 years:''' 18.1 per 100,000
**'''65 and over:''' 349.9 per 100,000


==Age==
===Race===


* While the overall age adjusted incidence of cancer of the lungs and bronchus in the United States between 2007 and 2011 is 60 per 100,000, the age-adjusted incidence of (insert disease state here) by age category is:
* In the United States, the age-adjusted [[prevalence]] of cancer of the [[lungs]] and [[bronchus]] by race in 2011 was:<ref name="SEER" />
** Under 65 years: 18.1 per 100,000
**'''Black:''' 70 - 95 per 100,000
** 65 and over: 349.9 per 100,000
**'''White:''' 50 - 70 per 100,000
**'''Asian/Pacific islander:''' 40 - 50 per 100,000
**'''Hispanic:''' 30 - 40 per 100,000


==Gender==
===Gender===
*[[Male|Males]] are thought to be more [[Predisposition|predisposed]] to the development of lung cancer. This gender discrepancy is often attributed to the historically increased rate of [[smoking]] among [[Male|males]] compared to [[Female|females]].
*The [[male]] to [[female]] ratio for the [[incidence]] of lung cancer is approximately 1.4 to 1.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref>


*In the United States, the age adjusted prevalence of cancer of the lungs and bronchus by gender in 2011 is:
===Developing Countries===
** In males: 0.1036 %
*The [[incidence]] of lung cancer is lower in the developing countries. It is unknown whether this decreased [[incidence]] is due to decreased [[cancer]] rates or decreased detection rates.<ref>{{cite web | title =Gender in lung cancer and smoking research | publisher =World Health Organization | date =2004 | url =http://www.who.int/gender/documents/en/lungcancerlow.pdf| format = PDF | accessdate =2007-05-26 }}</ref>
** In females: 0.985 %
*Eastern Europe has the highest lung cancer [[mortality]] among [[Male|men]].


*In the United States, the delay-adjusted incidence of cancer of the lungs and bronchus by gender in (insert year here) is:
===Developed Countries===
**In males: 66.17 per 100,000 persons
*Western Europe and the U.S. have the highest [[incidence]] of lung cancer and the highest [[mortality]] among women.
**In females: 49.62 per 100,000 persons
 
* In the United States, the age-adjusted incidence of cancer of the lungs and bronchus by gender on (insert year here) is:
** In males: 64.83 per 100,000 persons
** In females: 48.63 per 100,000 persons
 
Shown below is an image depicting the observed incidence and delay-adjusted incidence of cancer of the lungs and bronchus by gender and race in the United States between 1975 and 2011.
 
[[Image:Incidence of cancer of the lungs and bronchus.png]]
 
==Race==
 
* In the United States, the age adjusted prevalence of cancer of the lungs and bronchus by race in 2011 is:
** In all races: 0.1004 %
** In white: 0.1031 %
** In black: 0.1092 %
** In Asian/pacific islander: 0.0781 %
** In Hispanic: 0.0499 %
 
Shown below is an image depicting the incidence of cancer of the lungs and bronchus by race in the United States between (insert year range here).
 
[[Image:Incidence of cancer of the lungs and bronchus by race in the United States.png]]
 
==Percent Distribution of Cancer of the Lungs and Bronchus by Histology==
Among patients with histologically confirmed cases of cancer of the lungs and bronchus, the percent distribution of the types of the disease between 2004 and 2010 in the United States are:
* Carcinoma: 99.7%
** Small cell carcinoma: 13.4 %
** Non small cell carcinoma: 83.2 %
*** Squamous or transitional: 22%
*** Adenocarcinoma: 41.5%
*** Large cell: 2.3%
*** Non small cell carcinoma: 12.6%
*** Other specified carcinoma: 4.8%
** Carcinoma not otherwise specified:3.2%
* Sarcoma: 0.2 %
* Other specified types: 0.1%
 
==Age==
[[File:Cancer smoking lung cancer correlation from NIH.svg|frame|The incidence of lung cancer is highly correlated with smoking. Source: NIH.|left]]
<br clear="left"/>
Lung cancer is more common in older adults. Smoking can cause eventual death over a significant period of time, which explains why it is rare in people under the age of 45. There is a clear correlation between an increase in the volume of smoking and the total number of lung cancer deaths. Studies have shown that there is approximately a 20 year lag period between smoking and death due to lung cancer (in men).
 
==Gender==
Among male smokers, the lifetime risk of developing lung cancer is 17.2%. Among female smokers, the risk is 11.6%. This risk is significantly lower in non-smokers: 1.3% in men and 1.4% in women.<ref name="Villeneuve">{{cite journal | last =Villeneuve | first =PJ | coauthors =Mao Y | title =Lifetime probability of developing lung cancer, by smoking status, Canada | journal =Canadian Journal of Public Health | volume =85 | issue =6 | pages =385–388 | publisher = | date =Nov 1994 | pmid =7895211 }}</ref>
 
==Developed Countries==
Eastern Europe has the highest lung cancer mortality among men, while northern Europe and the U.S. have the highest mortality among women. Lung cancer incidence is currently less common in developing countries.<ref>{{cite web | title =Gender in lung cancer and smoking research | publisher =World Health Organization | date =2004 | url =http://www.who.int/gender/documents/en/lungcancerlow.pdf| format = PDF | accessdate =2007-05-26 }}</ref>
 
==Developing Countries==
With increased smoking in developing countries, the incidence is expected to increase in the next few years, notably in China<ref>{{cite journal | last=Liu | first=BQ | coauthors=Peto R, Chen ZM et al. |title=Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths | journal=British Medical Journal | volume=317 | issue=7170 | pages=1411–1422 | date=Nov 1998 | url=http://www.bmj.com/cgi/content/full/317/7170/1411| pmidbr=9822393 | accessdate=2007-09-27 }}</ref> and India.<ref>{{cite journal | last=Behera | first=D | coauthors=Balamugesh T |title=Lung cancer in India | journal=Indian Journal of Chest Diseases and Allied Sciences | volume=46 | issue=4 | pages=269-281 |date=2004 | pmid=15515828 }}</ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kim-Son H. Nguyen M.D. Cafer Zorkun, M.D., Ph.D. [2]; Rim Halaby, M.D. [3]; Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

Overview

Lung cancer is the most common cause of cancer-associated mortality and the second most common type of cancer among both genders. Individuals > 50 years of age who have a history of smoking are at increased risk. Historically, the incidence of lung cancer is significantly higher among males compared to females. This increased ratio is thought to be attributed to the increased rates of smoking among men. However, more women are being diagnosed with lung cancer due to the increased rate of smoking among women. In 2014, the incidence of lung cancer in the United States was approximately 70 cases per 100,000.

Epidemiology and Demographics

Incidence

  • In 2014, the incidence of lung cancer in the US alone was approximately 70 cases per 100,000.[1]
  • Being the most common cancer diagnosed worldwide, it accounted for 2.1 million new cases in 2018.[2]
  • In 2015, the US State Kentucky recorded the highest incidence rate in both men (105.6 per 100,000) and women (77.5 per 100,000) in the country.
  • In 2015, the US State Utah recorded the lowest incidence rate in both men (29.6 per 100,000) and women (22.1 per 100,000) in the country.

Prevalence

Mortality rate

  • Being the most common cancer diagnosed worldwide, lung cancer is responsible for 1.8 million deaths in 2018.[2]

Age

  • Lung cancer is more common in older adults. It is rare in people under age of 45 years.
  • While the overall age adjusted incidence of cancer of the lungs and bronchus in the United States between 2007 and 2011 is 60 per 100,000, the age-adjusted incidence of lung cancer by age category is:[3]
    • Under 65 years: 18.1 per 100,000
    • 65 and over: 349.9 per 100,000

Race

  • In the United States, the age-adjusted prevalence of cancer of the lungs and bronchus by race in 2011 was:[3]
    • Black: 70 - 95 per 100,000
    • White: 50 - 70 per 100,000
    • Asian/Pacific islander: 40 - 50 per 100,000
    • Hispanic: 30 - 40 per 100,000

Gender

  • Males are thought to be more predisposed to the development of lung cancer. This gender discrepancy is often attributed to the historically increased rate of smoking among males compared to females.
  • The male to female ratio for the incidence of lung cancer is approximately 1.4 to 1.[3]

Developing Countries

  • The incidence of lung cancer is lower in the developing countries. It is unknown whether this decreased incidence is due to decreased cancer rates or decreased detection rates.[7]
  • Eastern Europe has the highest lung cancer mortality among men.

Developed Countries

  • Western Europe and the U.S. have the highest incidence of lung cancer and the highest mortality among women.

References

  1. ↑ Siegel, Rebecca; Ma, Jiemin; Zou, Zhaohui; Jemal, Ahmedin (2014). "Cancer statistics, 2014". CA: A Cancer Journal for Clinicians. 64 (1): 9–29. doi:10.3322/caac.21208. ISSN 0007-9235.
  2. ↑ 2.0 2.1 https://www.who.int/news-room/fact-sheets/detail/cancer. Missing or empty |title= (help)
  3. ↑ 3.0 3.1 3.2 3.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
  4. ↑ https://www.cancer.org. Missing or empty |title= (help)
  5. ↑ 5.0 5.1 https://www.lung.org. Missing or empty |title= (help)
  6. ↑ 6.0 6.1 https://www.cdc.gov/nchs/data_access/cmf.htm. Missing or empty |title= (help)
  7. ↑ "Gender in lung cancer and smoking research" (PDF). World Health Organization. 2004. Retrieved 2007-05-26.

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