Epidemiology of lung cancer

Abstract

Conclusions: Although the peak of lung cancer incidence among men in North America, Australia, New Zealand, and northwestern Europe was reached in the 1980s, the rate for men in southern and eastern Europe and for women continued to increase, at least until the 1990s. In other parts of the world, where smoking is still increasing, mortality due to lung cancer will increase dramatically in the next decades. The geographic variation and trends in incidence were closely associated with past smoking behavior. The trend toward smoking more low-tar filter cigarettes probably caused the increase in the incidence of adenocarcinoma. This tumor type is already the major histological subtype in North America and may also become the major type in other countries in the near future. Lymphatic and hematogenous metastases are often present at the time that lung cancer is diagnosed, and prognosis is still very poor. The prognosis for non-small-cell lung cancer has only slightly improved, while considerable progress has been made in the short-term survival of small-cell lung cancer since the introduction of chemotherapy in the 1970s. Due to a growing proportion of elderly lung cancer patients, more patients present with serious comorbidity at diagnosis of cancer. This may complicate treatment and indicates the need for adapted guidelines for these patients, who usually are not entered in clinical trials. © 2006 Springer Berlin Heidelberg.