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Epidemiology of Lung Cancer - PowerPoint PPT Presentation


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Most frequently diagnosed cancer worldwide About 1.35 million new cases diagnosed worldwide each year Leading cause of cancer deaths in the United States. Incidence and mortality rates begin to increase between the ages of 45 and 54 and rise progressively until age 75

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PowerPoint Slideshow about 'Epidemiology of Lung Cancer' - PamelaLan


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  • Patterns of mortality tend to cluster with in areas with high prevalence of cigarette smoking

    • In the US, highest rates in Kentucky, lowest in Utah

    • Number of cases highest in California, lowest in Alaska

    • Worldwide, most cases are seen in the developed countries of North America, Western Europe, and Australia/New Zealand


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  • Current overall 5 year survival rate is 11% high prevalence of cigarette smoking

    • Impacted by age, tumor stage, histological subtype, and treatment

  • Developed countries have higher survival rates than developing countries (13% vs. 9%)

  • Improvements in diagnostic and therapeutic technologies have contributed to an increase in survival

    • 1 year survival 37% in 1975, 42% in 2000



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  • Cigarette smoking is the most important risk factor for lung cancer

    • Causes approximately 90% of male and 75-80% of female lung cancer deaths

  • By the early 1950s, case control studies in the US and Great Britain clearly showed an association between smoking and lung cancer

  • In 1964, the US Surgeon General released a report on the causal relationship


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  • United Kingdom cancer

    • Cumulative risk of death from lung cancer rose from 6% in 1950 to 16% in 1990 in male cigarette smokers

  • Relative risk of lung cancer after smoking cessation begins to decrease after 5 years but never reaches the risk of a non-smoker


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  • History of respiratory diseases such as asthma, bronchitis, emphysema, hay fever, or pneumonia may modify risk

  • When combined with smoking, there is a complementary cycle of injury and repair that may increase risk

  • Respiratory diseases may result in chronic immune stimulation that causes random pro-oncogenic mutations that increase risk

  • Relationship is still speculative


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  • IARC categorized several occupational agents as known carcinogens

    • Radon

      • Well established lung carcinogen, responsible for 6.5% of lung cancer deaths in the United Kingdom in 1998

    • Asbestos

      • SMR for lung cancer= 1.65, dose dependent risk

    • Arsenic

    • Bischloromthyl ether

    • Chromium

    • Nickel

    • Polycyclic aromatic compounds

    • Vinyl chloride


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  • Defective repair of genetic damage is an important determinant of susceptibility to lung cancer

    • Hypersensitivity to carcinogenic exposure

  • Many studies have demonstrated that cancer cases have a significant decrease in DNA repair capacity compared to controls


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  • Prevent smoking determinant of susceptibility to lung cancer

  • Screening

    • Early detection improves resectability and survival

    • Methods

      • Low-dose spiral CT

      • Combination of chest X-rays and sputum cytology

    • May only be cost-effective in high-risk populations


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  • Cancer Epidemiology, 3 changes in lung tissuerd ed. 2006. Oxford University Press

  • Centers for Disease Control

  • American Cancer Society


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Review Questions (Developed by the changes in lung tissueSupercourse team)

  • Why do you think lung cancer is the most frequently diagnosed cancer worldwide?

  • What is the reason for geographic variation in the rates of lung cancer?

  • Describe factors contributing to lung cancer development, other than smoking.

  • If somebody quits smoking, does the risk of cancer development return to the level of non-smoker? Describe the pattern.


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