Lung cancer: Difference between revisions
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==Signs and symptoms== |
==Signs and symptoms== |
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[[File:0619 LungCancer.png|thumb| |
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Signs and symptoms that may suggest lung cancer include:<ref name="Harrison" /> |
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* respiratory symptoms: [[coughing]], [[hemoptysis|coughing up blood]], [[wheeze|wheezing]] or [[dyspnea|shortness of breath]] |
* respiratory symptoms: [[coughing]], [[hemoptysis|coughing up blood]], [[wheeze|wheezing]] or [[dyspnea|shortness of breath]] |
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* systemic symptoms: weight loss, [[fever]], [[Nail clubbing|clubbing]] of the fingernails, or [[Fatigue (physical)|fatigue]] |
* systemic symptoms: weight loss, [[fever]], [[Nail clubbing|clubbing]] of the fingernails, or [[Fatigue (physical)|fatigue]] |
Revision as of 20:11, 1 August 2013
Lung cancer | |
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Specialty | Oncology, pulmonology ![]() |
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue or other parts of the body. Most cancers that start in lung, known as primary lung cancers, are carcinomas that derive from epithelial cells. The main types of lung cancer are small-cell lung carcinoma (SCLC), also called oat cell cancer, and non-small-cell lung carcinoma (NSCLC). The most common symptoms are coughing (including coughing up blood), weight loss and shortness of breath.[1]
The most common cause of lung cancer is long-term exposure to tobacco smoke,[2] which causes 80–90% of lung cancers.[1] Nonsmokers account for 10–15% of lung cancer cases,[3] and these cases are often attributed to a combination of genetic factors,[4] radon gas,[4] asbestos,[5] and air pollution[4] including second-hand smoke.[6][7] Lung cancer may be seen on chest radiograph and computed tomography (CT scan). The diagnosis is confirmed with a biopsy[8] which is usually performed by bronchoscopy or CT-guidance. Treatment and long-term outcomes depend on the type of cancer, the stage (degree of spread), and the person's overall health, measured by performance status.
Common treatments include surgery, chemotherapy, and radiotherapy. NSCLC is sometimes treated with surgery, whereas SCLC usually responds better to chemotherapy and radiotherapy.[9] Overall, 15% of people in the United States diagnosed with lung cancer survive five years after the diagnosis.[10] Worldwide, lung cancer is the most common cause of cancer-related death in men and women, and is responsible for 1.38 million deaths annually, as of 2008.[11]
Signs and symptoms
[[File:0619 LungCancer.png|thumb| />
- respiratory symptoms: coughing, coughing up blood, wheezing or shortness of breath
- systemic symptoms: weight loss, fever, clubbing of the fingernails, or fatigue
- symptom due to local compress: chest pain, bone pain, superior vena cava obstruction, difficulty swallowing
If the cancer grows in the airway, it may obstruct airflow, causing breathing difficulties. The obstruction can lead to accumulation of secretions behind the blockage, and predispose to pneumonia.[1]
Depending on the type of tumor, so-called paraneoplastic phenomena may initially attract attention to the disease.[12] In lung cancer, these phenomena may include Lambert–Eaton myasthenic syndrome (muscle weakness due to autoantibodies), hypercalcemia, or syndrome of inappropriate antidiuretic hormone (SIADH). Tumors in the top of the lung, known as Pancoast tumors, may invade the local part of the sympathetic nervous system, leading to Horner's syndrome (dropping of the eyelid and a small pupil on that side), as well as damage to the brachial plexus.[1]
Many of the symptoms of lung cancer (poor appetite, weight loss, fever, fatigue) are not specific.[8] In many people, the cancer has already spread beyond the original site by the time they have symptoms and seek medical attention. Common sites of spread include the brain, bone, adrenal glands, opposite lung, liver, pericardium, and kidneys.[13] About 10% of people with lung cancer do not have symptoms at diagnosis; these cancers are incidentally found on routine chest radiography.[10]
Causes
Cancer develops following genetic damage to DNA. This genetic damage affects the normal functions of the cell, including cell proliferation, programmed cell death (apoptosis) and DNA repair. As more damage accumulates, the risk of cancer increases.[14]
Smoking
![](http://upload.wikimedia.org/wikipedia/commons/thumb/9/94/Cancer_smoking_lung_cancer_correlation_from_NIH.svg/220px-Cancer_smoking_lung_cancer_correlation_from_NIH.svg.png)
[[File:cancerous lung.jpg|thumb|Cross section of a human lung: The white area in the upper lobe is cancer; the black areas are discoloration due to smoking.]] Smoking, particularly of cigarettes, is by far the main contributor to lung cancer.[15] Cigarette smoke contains over 60 known carcinogens,[16] including radioisotopes from the radon decay sequence, nitrosamine, and benzopyrene. Additionally, nicotine appears to depress the immune response to cancerous growths in exposed tissue.[17] Across the developed world, 90% of lung cancer deaths in men during the year 2000 were attributed to smoking (70% for women).[18] Smoking accounts for 80–90% of lung cancer cases.[1]
Passive smoking—the inhalation of smoke from another's smoking—is a cause of lung cancer in nonsmokers. A passive smoker can be classified as someone living or working with a smoker. Studies from the US,[19][20] Europe,[21] the UK,[22] and Australia[23] have consistently shown a significantly increased risk among those exposed to passive smoke.[24] Those who live with someone who smokes have a 20–30% increase in risk while those who work in an environment with second hand smoke have a 16–19% increase in risk.[25] Investigations of sidestream smoke suggest it is more dangerous than direct smoke.[26] Passive smoking causes about 3,400 deaths from lung cancer each year in the USA.[20]
Radon gas
Radon is a colorless and odorless gas generated by the breakdown of radioactive radium, which in turn is the decay product of uranium, found in the Earth's crust. The radiation decay products ionize genetic material, causing mutations that sometimes turn cancerous. Radon is the second-most common cause of lung cancer in the USA, after smoking.[20] The risk increases 8–16% for every 100 Bq/m³ increase in the radon concentration.[27] 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 one in 15 homes in the US has radon levels above the recommended guideline of 4 picocuries per liter (pCi/l) (148 Bq/m³).[28]
Asbestos
Asbestos can cause a variety of lung diseases, including lung cancer. Tobacco smoking and asbestos have a synergistic effect on the formation of lung cancer.[5] Asbestos can also cause cancer of the pleura, called mesothelioma (which is different from lung cancer).[29]
Air pollution
Outdoor air pollution has a small effect on increasing the risk of lung cancer.[4] Fine particulates (PM2.5) and sulfate aerosols, which may be released in traffic exhaust fumes, are associated with slightly increased risk.[4][30] For nitrogen dioxide, an incremental increase of 10 parts per billion increases the risk of lung cancer by 14%.[31] Outdoor air pollution is estimated to account for 1–2% of lung cancers.[4]
Tentative evidence supports an increased risk of lung cancer from indoor air pollution related to the burning of wood, charcoal, dung or crop residue for cooking and heating.[32] Women who are exposed to indoor coal smoke have about twice the risk and a number of the by-products of burning biomass are known or suspected carcinogens.[33] This risk affects about 2.4 billion people globally,[32] and is believed to account for 1.5% of lung cancer deaths.[33]
Genetics
It is estimated that 8 to 14% of lung cancer is due to inherited factors.[34] In relatives of people with lung cancer, the risk is increased 2.4 times. This is likely due to a combination of genes.[35]
Other causes
Numerous other substances, occupations, and environmental exposures have been linked to lung cancer. The International Agency for Research on Cancer (IARC) states there is "sufficient evidence" to show the following are carcinogenic in lung:[36]
- Some metals (aluminum production, cadmium and cadmium compounds, chromium(VI) compounds, beryllium and beryllium compounds, iron and steel founding, nickel compounds, arsenic and inorganic arsenic compounds, underground hematite mining)
- Some products of combustion (incomplete combustion, coal (indoor emissions from household coal burning), coal gasification, coal-tar pitch, coke production, soot, diesel engine exhaust)
- Ionizing radiation (X-radiation, radon-222 and its decay products, gamma radiation, plutonium)
- Some toxic gases (methyl ether (technical grade), Bis-(chloromethyl) ether, sulfur mustard, MOPP (vincristine-prednisone-nitrogen mustard-procarbazine mixture), fumes from painting)
- Rubber production and crystalline silica dust
Pathogenesis
Similar to many other cancers, lung cancer is initiated by activation of oncogenes or inactivation of tumor suppressor genes.[37] Oncogenes are believed to make people more susceptible to cancer. Proto-oncogenes are believed to turn into oncogenes when exposed to particular carcinogens.[38] Mutations in the K-ras proto-oncogene are responsible for 10–30% of lung adenocarcinomas.[39][40] The epidermal growth factor receptor (EGFR) regulates cell proliferation, apoptosis, angiogenesis, and tumor invasion.[39] Mutations and amplification of EGFR are common in non-small-cell lung cancer and provide the basis for treatment with EGFR-inhibitors. Her2/neu is affected less frequently.[39] Chromosomal damage can lead to loss of heterozygosity. This can cause inactivation of tumor suppressor genes. Damage to chromosomes 3p, 5q, 13q, and 17p are particularly common in small-cell lung carcinoma. The p53 tumor suppressor gene, located on chromosome 17p, is affected in 60-75% of cases.[41] Other genes that are often mutated or amplified are c-MET, NKX2-1, LKB1, PIK3CA, and BRAF.[39]
Diagnosis
![](http://upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Thorax_CT_peripheres_Brronchialcarcinom_li_OF.jpg/220px-Thorax_CT_peripheres_Brronchialcarcinom_li_OF.jpg)
Performing a chest radiograph is one of the first investigative steps if a person reports symptoms that may suggest lung cancer. This may reveal an obvious mass, widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (collapse), consolidation (pneumonia), or pleural effusion.[2] CT imaging is typically used to provide more information about the type and extent of disease. Bronchoscopy or CT-guided biopsy is often used to sample the tumor for histopathology.[10]
Lung cancer often appears as a solitary pulmonary nodule on a chest radiograph. However, the differential diagnosis is wide. Many other diseases can also give this appearance, including tuberculosis, fungal infections, metastatic cancer, or organizing pneumonia. Less common causes of a solitary pulmonary nodule include hamartomas, bronchogenic cysts, adenomas, arteriovenous malformation, pulmonary sequestration, rheumatoid nodules, Wegener's granulomatosis, or lymphoma.[42] Lung cancer can also be an incidental finding, as a solitary pulmonary nodule on a chest radiograph or CT scan done for an unrelated reason.[43] The definitive diagnosis of lung cancer is based on histological examination of the suspicious tissue in the context of the clinical and radiological features.[1]
Classification
Histological type | Incidence per 100,000 per year |
---|---|
All types | 66.9 |
Adenocarcinoma | 22.1 |
Squamous-cell carcinoma | 14.4 |
Small-cell carcinoma | 9.8 |
Lung cancers are classified according to histological type.[8] This classification is important for determining management and predicting outcomes of the disease. The vast majority of lung cancers are carcinomas—malignancies that arise from epithelial cells. Lung carcinomas are categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope. The two broad classes are non-small-cell and small-cell lung carcinoma.[44]
Non-small-cell lung carcinoma
![](http://upload.wikimedia.org/wikipedia/commons/thumb/5/53/Squamous_carcinoma_lung_2_cytology.jpg/220px-Squamous_carcinoma_lung_2_cytology.jpg)
The three main subtypes of NSCLC are adenocarcinoma, squamous-cell lung carcinoma, and large-cell lung carcinoma.[1]
Nearly 40% of lung cancers are adenocarcinoma, which usually originates in peripheral lung tissue.[8] Most cases of adenocarcinoma are associated with smoking; however, among people who have smoked fewer than 100 cigarettes in their lifetimes ("never-smokers"),[1] adenocarcinoma is the most common form of lung cancer.[45] A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have a better long term survival.[46]
Squamous-cell carcinoma accounts for about 30% of lung cancers. They typically occur close to large airways. A hollow cavity and associated cell death are commonly found at the center of the tumor.[8] About 9% of lung cancers are large-cell carcinoma. These are so named because the cancer cells are large, with excess cytoplasm, large nuclei and conspicuous nucleoli.[8]
Small-cell lung carcinoma
![](http://upload.wikimedia.org/wikipedia/commons/thumb/5/54/Lung_small_cell_carcinoma_%281%29_by_core_needle_biopsy.jpg/220px-Lung_small_cell_carcinoma_%281%29_by_core_needle_biopsy.jpg)
In small-cell lung carcinoma (SCLC), the cells contain dense neurosecretory granules (vesicles containing neuroendocrine hormones), which give this tumor an endocrine/paraneoplastic syndrome association.[47] Most cases arise in the larger airways (primary and secondary bronchi).[10] These cancers grow quickly and spread early in the course of the disease. Sixty to seventy percent have metastatic disease at presentation. This type of lung cancer is strongly associated with smoking.[1]
Others
Four main histological subtypes are recognized, although some cancers may contain a combination of different subtypes.[44] Rare subtypes include glandular tumors, carcinoid tumors, and undifferentiated carcinomas.[1]
Metastasis
Histological type | Immunostain |
---|---|
Squamous-cell carcinoma | CK5/6 positive CK7 negative |
Adenocarcinoma | CK7 positive TTF-1 positive |
Large-cell carcinoma | TTF-1 negative |
Small-cell carcinoma | TTF-1 positive CD56 positive Chromogranin positive Synaptophysin positive |
The lung is a common place for the spread of tumors from other parts of the body. Secondary cancers are classified by the site of origin; e.g., breast cancer that has spread to the lung is called metastatic breast cancer. Metastases often have a characteristic round appearance on chest radiograph.[48]
Primary lung cancers themselves most commonly metastasize to the brain, bones, liver, and adrenal glands.[8] Immunostaining of a biopsy is often helpful to determine the original source.[49]
Staging
Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is one of the factors affecting the prognosis and potential treatment of lung cancer.[1]
The initial evaluation of non-small-cell lung cancer (NSCLC) staging uses the TNM classification. This is based on the size of the primary tumor, lymph node involvement, and distant metastasis. After this, using the TNM descriptors, a group is assigned, ranging from occult cancer, through stages 0, IA (one-A), IB, IIA, IIB, IIIA, IIIB and IV (four). This stage group assists with the choice of treatment and estimation of prognosis.[50] Small-cell lung carcinoma (SCLC) has traditionally been classified as 'limited stage' (confined to one half of the chest and within the scope of a single tolerable radiotherapy field) or 'extensive stage' (more widespread disease).[1] However, the TNM classification and grouping are useful in estimating prognosis.[50]
For both NSCLC and SCLC, the two general types of staging evaluations are clinical staging and surgical staging. Clinical staging is performed prior to definitive surgery. It is based on the results of imaging studies (such as CT scans and PET scans) and biopsy results. Surgical staging is evaluated either during or after the operation, and is based on the combined results of surgical and clinical findings, including surgical sampling of thoracic lymph nodes.[8]
Prevention
Prevention is the most cost-effective means of decreasing lung cancer development. While in most countries industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the prevention of lung cancer, and smoking cessation is an important preventive tool in this process.[51]
Policy interventions to decrease passive smoking in public areas such as restaurants and workplaces have become more common in many Western countries.[52] Bhutan has had a complete smoking ban since 2005[53] while India introduced a ban on smoking in public in October 2008.[54] The World Health Organization has called for governments to institute a total ban on tobacco advertising to prevent young people from taking up smoking. They assess that such bans have reduced tobacco consumption by 16% where instituted.[55]
The long-term use of supplemental vitamin A,[56][57] vitamin C,[56] vitamin D[58] or vitamin E[56] does not reduce the risk of lung cancer. Some studies suggest people who eat diets with a higher proportion of vegetables and fruit tend have a lower risk,[20][59] but this is likely due to confounding. More rigorous studies have not demonstrated a clear association.[59]
Screening
Screening refers to the use of medical tests to detect disease in asymptomatic people. Possible screening tests for lung cancer include sputum cytology, chest radiograph (CXR), and computed tomography (CT). Screening programs using CXR or cytology have not demonstrated benefit.[60] Screening those at high risk (i.e. age 55 to 79 who have smoked more than 30 pack years or those who have had previous lung cancer) annually with low-dose CT scans may reduce the chance of death from lung cancer by an absolute amount of 0.3% (relative amount of 20%).[61][62] There is, however, a high rate of falsely positive scans which may result in unneeded invasive procedures as well as substantial financial cost.[63] For each true positive scan there are more than 19 false positives.[64] Radiation exposure is another potential harm from screening.[65]
Management
Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread, and the person's performance status. Common treatments include palliative care,[66] surgery, chemotherapy, and radiation therapy.[1]
Surgery
![](http://upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Lung_cancer.jpg/220px-Lung_cancer.jpg)
If investigations confirm NSCLC, the stage is assessed to determine whether the disease is localized and amenable to surgery or if it has spread to the point where it cannot be cured surgically. CT scan and positron emission tomography are used for this determination.[1] If mediastinal lymph node involvement is suspected, mediastinoscopy may be used to sample the nodes and assist staging.[67] Blood tests and pulmonary function testing are used to assess whether a person is well enough for surgery.[10] If pulmonary function tests reveal poor respiratory reserve, surgery may not be a possibility.[1]
In most cases of early-stage NSCLC, removal of a lobe of lung (lobectomy) is the surgical treatment of choice. In people who are unfit for a full lobectomy, a smaller sublobar excision (wedge resection) may be performed. However, wedge resection has a higher risk of recurrence than lobectomy.[68] Radioactive iodine brachytherapy at the margins of wedge excision may reduce the risk of recurrence.[69] Rarely, removal of a whole lung (pneumonectomy) is performed.[68] Video-assisted thoracoscopic surgery and VATS lobectomy use a minimally invasive approach to lung cancer surgery.[70] VATS lobectomy is equally effective compared to conventional open lobectomy, with less postoperative illness.[71]
In SCLC, chemotherapy and/or radiotherapy is typically used.[72] However the role of surgery in SCLC is being reconsidered. Surgery might improve outcomes when added to chemotherapy and radiation in early stage SCLC.[73]
Radiotherapy
Radiotherapy is often given together with chemotherapy, and may be used with curative intent in people with NSCLC who are not eligible for surgery. This form of high-intensity radiotherapy is called radical radiotherapy.[74] A refinement of this technique is continuous hyperfractionated accelerated radiotherapy (CHART), in which a high dose of radiotherapy is given in a short time period.[75] Postoperative thoracic radiotherapy generally should not be used after curative intent surgery for NSCLC.[76] Some people with mediastinal N2 lymph node involvement might benefit from post-operative radiotherapy.[77]
For potentially curable SCLC cases, chest radiotherapy is often recommended in addition to chemotherapy.[8]
If cancer growth blocks a short section of bronchus, brachytherapy (localized radiotherapy) may be given directly inside the airway to open the passage.[78] Compared to external beam radiotherapy, brachytherapy allows a reduction in treatment time and reduced radiation exposure to healthcare staff.[79]
Prophylactic cranial irradiation (PCI) is a type of radiotherapy to the brain, used to reduce the risk of metastasis. PCI is most useful in SCLC. In limited-stage disease, PCI increases three-year survival from 15% to 20%; in extensive disease, one-year survival increases from 13% to 27%.[80]
Recent improvements in targeting and imaging have led to the development of stereotactic radiation in the treatment of early-stage lung cancer. In this form of radiotherapy, high doses are delivered in a small number of sessions using stereotactic targeting techniques. Its use is primarily in patients who are not surgical candidates due to medical comorbidities.[81]
For both NSCLC and SCLC patients, smaller doses of radiation to the chest may be used for symptom control (palliative radiotherapy).[82]
Chemotherapy
The chemotherapy regimen depends on the tumor type.[8] Small-cell lung carcinoma (SCLC), even relatively early stage disease, is treated primarily with chemotherapy and radiation.[83] In SCLC, cisplatin and etoposide are most commonly used.[84] Combinations with carboplatin, gemcitabine, paclitaxel, vinorelbine, topotecan, and irinotecan are also used.[85][86] In advanced non-small cell lung carcinoma (NSCLC), chemotherapy improves survival and is used as first-line treatment, provided the person is well enough for the treatment.[87] Typically, two drugs are used, of which one is often platinum-based (either cisplatin or carboplatin). Other commonly used drugs are gemcitabine, paclitaxel, docetaxel,[88][89] pemetrexed,[90] etoposide or vinorelbine.[89]
Adjuvant chemotherapy refers to the use of chemotherapy after apparently curative surgery to improve the outcome. In NSCLC, samples are taken of nearby lymph nodes during surgery to assist staging. If stage II or III disease is confirmed, adjuvant chemotherapy improves survival by 5% at five years.[91][92] The combination of vinorelbine and cisplatin is more effective than older regimens.[92] Adjuvant chemotherapy for people with stage IB cancer is controversial, as clinical trials have not clearly demonstrated a survival benefit.[93][94] Trials of preoperative chemotherapy (neoadjuvant chemotherapy) in resectable NSCLC have been inconclusive.[95]
Palliative care
In people with terminal disease, palliative care or hospice management may be appropriate.[10] These approaches allow additional discussion of treatment options and provide opportunities to arrive at well-considered decisions[96][97] and may avoid unhelpful but expensive care at the end of life.[97]
Chemotherapy may be combined with palliative care in the treatment of the NSCLC. In advanced cases, appropriate chemotherapy improves average survival over supportive care alone, as well as improving quality of life.[98] With adequate physical fitness, maintaining chemotherapy during lung cancer palliation offers 1.5 to 3 months of prolongation of survival, symptomatic relief, and an improvement in quality of life, with better results seen with modern agents.[99][100] The NSCLC Meta-Analyses Collaborative Group recommends if the recipient wants and can tolerate treatment, then chemotherapy should be considered in advanced NSCLC.[87][101]
Prognosis
Clinical stage | Five-year survival (%) | |
---|---|---|
Non-small cell lung carcinoma | Small cell lung carcinoma | |
IA | 50 | 38 |
IB | 47 | 21 |
IIA | 36 | 38 |
IIB | 26 | 18 |
IIIA | 19 | 13 |
IIIB | 7 | 9 |
IV | 2 | 1 |
Prognosis is generally poor. Of all people with lung cancer, 15% survive for five years after diagnosis.[2] Stage is often advanced at the time of diagnosis. At presentation, 30–40% of cases of NSCLC are stage IV, and 60% of SCLC are stage IV.[8]
Prognostic factors in NSCLC include presence or absence of pulmonary symptoms, tumor size, cell type (histology), degree of spread (stage) and metastases to multiple lymph nodes, and vascular invasion. For people with inoperable disease, outcomes are worse in those with poor performance status and weight loss of more than 10%.[102] Prognostic factors in small cell lung cancer include performance status, gender, stage of disease, and involvement of the central nervous system or liver at the time of diagnosis.[103]
For NSCLC, the best prognosis is achieved with complete surgical resection of stage IA disease, with up to 70% five-year survival.[104] For SCLC, the overall five-year survival is about 5%.[1] People with extensive-stage SCLC have an average five-year survival rate of less than 1%. The average survival time for limited-stage disease is 20 months, with a five-year survival rate of 20%.[2]
According to data provided by the National Cancer Institute, the median age at diagnosis of lung cancer in the United States is 70 years,[105] and the median age at death is 72 years.[106] In the US, people with medical insurance are more likely to have a better outcome.[107]
Epidemiology
![](http://upload.wikimedia.org/wikipedia/commons/thumb/5/5a/Trachea%2C_bronchus%2C_lung_cancers_world_map_-_Death_-_WHO2004.svg/220px-Trachea%2C_bronchus%2C_lung_cancers_world_map_-_Death_-_WHO2004.svg.png)
![](http://upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Lung_cancer_US_distribution.gif/220px-Lung_cancer_US_distribution.gif)
Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality. In 2008, there were 1.61 million new cases, and 1.38 million deaths due to lung cancer. The highest rates are in Europe and North America.[11] The population segment most likely to develop lung cancer is people aged over 50 who have a history of smoking. In contrast to the mortality rate in men, which began declining more than 20 years ago, women's lung cancer mortality rates have been rising over the last decades, and are just recently beginning to stabilize.[109] In the USA, the lifetime risk of developing lung cancer is 8% in men and 6% in women.[1]
For every 3–4 million cigarettes smoked, one lung cancer death occurs.[1][110] The influence of "Big Tobacco" plays a significant role in the smoking culture.[111] Young nonsmokers who see tobacco advertisements are more likely to take up smoking.[112] The role of passive smoking is increasingly being recognized as a risk factor for lung cancer,[24] leading to policy interventions to decrease undesired exposure of nonsmokers to others' tobacco smoke.[113] Emissions from automobiles, factories, and power plants also pose potential risks.[4]
Eastern Europe has the highest lung cancer mortality among men, while northern Europe and the US have the highest mortality among women. In the United States, black men and women have a higher incidence.[114] Lung cancer rates are currently lower in developing countries.[115] With increased smoking in developing countries, the rates are expected to increase in the next few years, notably in China[116] and India.[117]
From the 1960s, the rates of lung adenocarcinoma started to rise relative to other types of lung cancer. This is partly due to the introduction of filter cigarettes. The use of filters removes larger particles from tobacco smoke, thus reducing deposition in larger airways. However, the smoker has to inhale more deeply to receive the same amount of nicotine, increasing particle deposition in small airways where adenocarcinoma tends to arise.[118] The incidence of lung adenocarcinoma continues to rise.[119]
History
Lung cancer was uncommon before the advent of cigarette smoking; it was not even recognized as a distinct disease until 1761.[120] Different aspects of lung cancer were described further in 1810.[121] Malignant lung tumors made up only 1% of all cancers seen at autopsy in 1878, but had risen to 10–15% by the early 1900s.[122] Case reports in the medical literature numbered only 374 worldwide in 1912,[123] but a review of autopsies showed the incidence of lung cancer had increased from 0.3% in 1852 to 5.66% in 1952.[124] In Germany in 1929, physician Fritz Lickint recognized the link between smoking and lung cancer,[122] which led to an aggressive antismoking campaign.[125] The British Doctors Study, published in the 1950s, was the first solid epidemiological evidence of the link between lung cancer and smoking.[126] As a result, in 1964 the Surgeon General of the United States recommended smokers should stop smoking.[127]
The connection with radon gas was first recognized among miners in the Ore Mountains near Schneeberg, Saxony. Silver has been mined there since 1470, and these mines are rich in uranium, with its accompanying radium and radon gas.[128] Miners developed a disproportionate amount of lung disease, eventually recognized as lung cancer in the 1870s.[129] Despite this discovery, mining continued into the 1950s, due to the USSR's demand for uranium.[128] Radon was confirmed as a cause of lung cancer in the 1960s.[130]
The first successful pneumonectomy for lung cancer was performed in 1933.[131] Palliative radiotherapy has been used since the 1940s.[132] Radical radiotherapy, initially used in the 1950s, was an attempt to use larger radiation doses in patients with relatively early-stage lung cancer, but who were otherwise unfit for surgery.[133] In 1997, continuous hyperfractionated accelerated radiotherapy was seen as an improvement over conventional radical radiotherapy.[134] With small-cell lung carcinoma, initial attempts in the 1960s at surgical resection[135] and radical radiotherapy[136] were unsuccessful. In the 1970s, successful chemotherapy regimens were developed.[137]
References
- ^ a b c d e f g h i j k l m n o p q r s Horn, L (2012). "Chapter 89". Harrison's Principles of Internal Medicine (18th ed.). McGraw-Hill. ISBN 0-07-174889-X.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ a b c d "Lung Carcinoma: Tumors of the Lungs". Merck Manual Professional Edition, Online edition. Retrieved 2007-08-15.
- ^ Thun, MJ (2008). "Lung cancer occurrence in never-smokers: an analysis of 13 cohorts and 22 cancer registry studies". PLoS Medicine. 5 (9): e185. doi:10.1371/journal.pmed.0050185. PMC 2531137. PMID 18788891.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help)CS1 maint: unflagged free DOI (link) - ^ a b c d e f g h Alberg AJ, Samet JM (2010). "Chapter 46". Murray & Nadel's Textbook of Respiratory Medicine (5th ed.). Saunders Elsevier. ISBN 978-1-4160-4710-0.
- ^ a b O'Reilly, KM (2007). "Asbestos-related lung disease". American Family Physician. 75 (5): 683–688. PMID 17375514.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Carmona, RH (2006-06-27). "The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General". U.S. Department of Health and Human Services.
Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke.
- ^ "Tobacco Smoke and Involuntary Smoking" (PDF). IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. 83. WHO International Agency for Research on Cancer. 2002.
There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans. [...] Involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) is carcinogenic to humans (Group 1).
- ^ a b c d e f g h i j k Lu, C (2010). "78: Cancer of the Lung". Holland-Frei Cancer Medicine (8th ed.). People's Medical Publishing House. ISBN 9781607950141.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Chapman, S (2009). "Chapter 31". Oxford Handbook of Respiratory Medicine (2nd ed.). Oxford University Press. ISBN 9-780199-545162.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ a b c d e f Collins, LG (2007). "Lung cancer: diagnosis and management". American Family Physician. 75 (1). American Academy of Family Physicians: 56–63. PMID 17225705.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b Ferlay, J (December 2010). "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008". International Journal of Cancer. 127 (12): 2893–2917. doi:10.1002/ijc.25516. PMID 21351269.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Honnorat, J (2007). "Paraneoplastic neurological syndromes". Orphanet Journal of Rare Diseases. 2 (1). BioMed Central: 22. doi:10.1186/1750-1172-2-22. PMC 1868710. PMID 17480225.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help)CS1 maint: unflagged free DOI (link) - ^ Greene, Frederick L. (2002). AJCC cancer staging manual. Berlin: Springer-Verlag. ISBN 0-387-95271-3.
- ^ Brown, KM (2010). "8". Holland-Frei Cancer Medicine (8th ed.). People's Medical Publishing House USA. ISBN 978-1607950141.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Biesalski, HK (1998). "European Consensus Statement on Lung Cancer: risk factors and prevention. Lung Cancer Panel". CA Cancer J Clin. 48 (3). Smoking is the major risk factor, accounting for about 90% of lung cancer incidence.: 167–176, discussion 164–166. doi:10.3322/canjclin.48.3.167. PMID 9594919.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help)CS1 maint: location (link) - ^ Hecht, S (2003). "Tobacco carcinogens, their biomarkers and tobacco-induced cancer". Nature Reviews. Cancer. 3 (10). Nature Publishing Group: 733–744. doi:10.1038/nrc1190. PMID 14570033.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Sopori, M (2002). "Effects of cigarette smoke on the immune system". Nature Reviews. Immunology. 2 (5): 372–7. doi:10.1038/nri803. PMID 12033743.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Peto, R (2006). Mortality from smoking in developed countries 1950–2000: Indirect estimates from National Vital Statistics. Oxford University Press. ISBN 0-19-262535-7.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ California Environmental Protection Agency (1997). "Health effects of exposure to environmental tobacco smoke. California Environmental Protection Agency". Tobacco Control. 6 (4): 346–353. doi:10.1136/tc.6.4.346. PMC 1759599. PMID 9583639.
* CDC (2001). "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000". Morbidity and Mortality Weekly Report. 50 (49). Atlanta, Georgia: CDC: 1101–1106. PMID 11794619.{{cite journal}}
: More than one of|author1=
and|last=
specified (help); Unknown parameter|month=
ignored (help) - ^ a b c d Alberg, AJ (2007). "Epidemiology of lung cancer". Chest. 132 (S3). American College of Chest Physicians: 29S–55S. doi:10.1378/chest.07-1347. PMID 17873159.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Jaakkola, MS (2006). "Impact of smoke-free workplace legislation on exposures and health: possibilities for prevention". European Respiratory Journal. 28 (2): 397–408. doi:10.1183/09031936.06.00001306. PMID 16880370.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Parkin, DM (2011). "Tobacco—attributable cancer burden in the UK in 2010". British Journal of Cancer. 105 (Suppl. 2): S6–S13. doi:10.1038/bjc.2011.475. PMC 3252064. PMID 22158323.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ National Health and Medical Research Council (April 1994). "The health effects and regulation of passive smoking". Australian Government Publishing Service. Archived from the original on September 29, 2007. Retrieved 2007-08-10.
{{cite journal}}
: Cite journal requires|journal=
(help) - ^ a b Taylor, R (2007). "Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent". International Journal of Epidemiology. 36 (5): 1048–1059. doi:10.1093/ije/dym158. PMID 17690135.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ "Frequently asked questions about second hand smoke". World Health Organization. Retrieved 25 July 2012.
- ^ Schick, S (2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tobacco Control. 14 (6): 396–404. doi:10.1136/tc.2005.011288. PMC 1748121. PMID 16319363.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Schmid K, Kuwert T, Drexler H (2010). "Radon in Indoor Spaces: An Underestimated Risk Factor for Lung Cancer in Environmental Medicine". Dtsch Arztebl Int. 107 (11): 181–6. doi:10.3238/arztebl.2010.0181. PMC 2853156. PMID 20386676.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) - ^ EPA (2006). "Radiation information: radon". EPA. Retrieved 2007-08-11.
{{cite web}}
: Unknown parameter|month=
ignored (help) - ^ Davies, RJO (2010). "18.19.3". Oxford Textbook Medicine (5th ed.). OUP Oxford. ISBN 978-0199204854.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Chen, H (2008). "A systematic review of the relation between long-term exposure to ambient air pollution and chronic diseases". Reviews on Environmental Health. 23 (4): 243–297. PMID 19235364.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Clapp, RW (2008). "Environmental and Occupational Causes of Cancer New Evidence, 2005–2007". Reviews on Environmental Health. 23 (1): 1–37. PMC 2791455. PMID 18557596.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b Lim, WY (2012 Jan). "Biomass fuels and lung cancer". Respirology (Carlton, Vic.). 17 (1): 20–31. PMID 22008241.
{{cite journal}}
: Check date values in:|date=
(help); Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ a b Sood, A (2012 Dec). "Indoor fuel exposure and the lung in both developing and developed countries: an update". Clinics in chest medicine. 33 (4): 649–65. PMID 23153607.
{{cite journal}}
: Check date values in:|date=
(help) - ^ Dudley, Joel (2013). Exploring Personal Genomics. Oxford University Press. p. 25. ISBN 9780199644483.
- ^ Kern JA, McLennan G (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 1802. ISBN 0-07-145739-9.
- ^ Cogliano, VJ (2011 Dec 21). "Preventable exposures associated with human cancers" (PDF). Journal of the National Cancer Institute. 103 (24): 1827–39. PMID 22158127.
{{cite journal}}
: Check date values in:|date=
(help); Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Fong, KM (2003). "Lung cancer • 9: Molecular biology of lung cancer: clinical implications". Thorax. 58 (10). BMJ Publishing Group Ltd.: 892–900. doi:10.1136/thorax.58.10.892. PMC 1746489. PMID 14514947.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Salgia, R (1998). "Molecular abnormalities in lung cancer". Journal of Clinical Oncology. 16 (3): 1207–1217. PMID 9508209.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b c d Herbst, RS (2008). "Lung cancer". New England Journal of Medicine. 359 (13): 1367–1380. doi:10.1056/NEJMra0802714. PMID 18815398.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Aviel-Ronen, S (2006). "K-ras mutations in non-small-cell lung carcinoma: a review". Clinical Lung Cancer. 8 (1). Cancer Information Group: 30–38. doi:10.3816/CLC.2006.n.030. PMID 16870043.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Devereux, TR (1996). "Molecular mechanisms of lung cancer. Interaction of environmental and genetic factors". Chest. 109 (Suppl 3). American College of Chest Physicians: 14S–19S. doi:10.1378/chest.109.3_Supplement.14S. PMID 8598134.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Miller, WT (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 486. ISBN 0-07-145739-9.
- ^ Kaiser, LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 1815–1816. ISBN 0-07-145739-9.
- ^ a b Maitra, A (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 528–529. ISBN 978-1-4160-2973-1.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Subramanian, J (2007). "Lung cancer in never smokers: a review". Journal of Clinical Oncology. 25 (5). American Society of Clinical Oncology: 561–570. doi:10.1200/JCO.2006.06.8015. PMID 17290066.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Raz, DJ (2006). "Bronchioloalveolar carcinoma: a review". Clinical Lung Cancer. 7 (5): 313–322. doi:10.3816/CLC.2006.n.012. PMID 16640802.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Rosti, G (2006). "Small cell lung cancer". Annals of Oncology. 17 (Suppl. 2): 5–10. doi:10.1093/annonc/mdj910. PMID 16608983.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Seo, JB (1 March 2001). "Atypical pulmonary metastases: spectrum of radiologic findings". Radiographics. 21 (2): 403–417. PMID 11259704.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Tan D, Zander DS (2008). "Immunohistochemistry for Assessment of Pulmonary and Pleural Neoplasms: A Review and Update". Int J Clin Exp Pathol. 1 (1): 19–31. PMC 2480532. PMID 18784820.
- ^ a b c Rami-Porta, R (2009). "The revised TNM staging system for lung cancer" (PDF). Annals of Thoracic and Cardiovascular Surgery. 15 (1): 4–9. PMID 19262443.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Goodman, GE (2002). "Lung cancer. 1: prevention of lung cancer" (PDF). Thorax. 57 (11): 994–999. PMC 1746232. PMID 12403886.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ McNabola, A (2009). "The control of environmental tobacco smoke: a policy review". International Journal of Environmental Research and Public Health. 6 (2): 741–758. doi:10.3390/ijerph6020741. PMC 2672352. PMID 19440413.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help)CS1 maint: unflagged free DOI (link) - ^ Pandey, G (2005). "Bhutan's smokers face public ban". BBC. Retrieved 2007-09-07.
{{cite news}}
: Unknown parameter|month=
ignored (help) - ^ Pandey, G (2 October 2008). "Indian ban on smoking in public". BBC. Retrieved 2012-04-25.
- ^ "UN health agency calls for total ban on tobacco advertising to protect young" (Press release). United Nations News service. 30 May 2008.
- ^ a b c Fabricius, P (2003). "Diet and lung cancer". Monaldi Archives for Chest Disease. 59 (3): 207–211. PMID 15065316.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Fritz, H (2011). "Vitamin A and Retinoid Derivatives for Lung Cancer: A Systematic Review and Meta Analysis". PLoS ONE. 6 (6): e21107. doi:10.1371/journal.pone.0021107. PMC 3124481. PMID 21738614.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help)CS1 maint: unflagged free DOI (link) - ^ Herr, C (2011). "The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer". Respiratory Research. 12 (1): 31. doi:10.1186/1465-9921-12-31. PMC 3071319. PMID 21418564.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help)CS1 maint: unflagged free DOI (link) - ^ a b Key, TJ (2011). "Fruit and vegetables and cancer risk". British Journal of Cancer. 104 (1): 6–11. doi:10.1038/sj.bjc.6606032. PMC 3039795. PMID 21119663.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Manser, RL (2004). "Screening for lung cancer". Cochrane Database of Systematic Reviews (1): CD001991. doi:10.1002/14651858.CD001991.pub2. PMID 14973979.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Jaklitsch, MT (2012). "The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups". Journal of Thoracic and Cardiovascular Surgery. 144 (1): 33–38. doi:10.1016/j.jtcvs.2012.05.060. PMID 22710039.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Bach, PB (2012). "Benefits and harms of CT screening for lung cancer: a systematic review". JAMA: the Journal of the American Medical Association. 307 (22): 2418–2429. doi:10.1001/jama.2012.5521. PMID 22610500.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Boiselle, PM (2013 Mar 20). "Computed tomography screening for lung cancer". JAMA : the journal of the American Medical Association. 309 (11): 1163–70. PMID 23512063.
{{cite journal}}
: Check date values in:|date=
(help) - ^ Bach PB, Mirkin JN, Oliver TK; et al. (2012). "Benefits and harms of CT screening for lung cancer: a systematic review". JAMA. 307 (22): 2418–29. doi:10.1001/jama.2012.5521. PMID 22610500.
{{cite journal}}
: Explicit use of et al. in:|author=
(help); Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) - ^ Aberle, DR (2013 Mar 10). "Computed tomography screening for lung cancer: has it finally arrived? Implications of the national lung screening trial". Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 31 (8): 1002–8. PMID 23401434.
{{cite journal}}
: Check date values in:|date=
(help); Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Ferrell, B (2011). "Palliative care in lung cancer". Surgical Clinics of North America. 91 (2): 403–417. doi:10.1016/j.suc.2010.12.003. PMID 21419260.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 1853–1854. ISBN 0-07-145739-9.
- ^ a b Kaiser LR (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. pp. 1855–1856. ISBN 0-07-145739-9.
- ^ Odell, DD (2010). "Sublobar resection with brachytherapy mesh for stage I non-small cell lung cancer". Seminars in Thoracic and Cardiovascular Surgery. 22 (1): 32–37. doi:10.1053/j.semtcvs.2010.04.003. PMID 20813314.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Alam, N (2007). "Video-assisted thoracic surgery (VATS) lobectomy: the evidence base". Journal of the Society of Laparoendoscopic Surgeons. 11 (3): 368–374. PMC 3015831. PMID 17931521.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Rueth, NM (2010). "Is VATS lobectomy better: perioperatively, biologically and oncologically?". Annals of Thoracic Surgery. 89 (6): S2107–S2111. doi:10.1016/j.athoracsur.2010.03.020. PMID 20493991.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Simon GR, Turrisi A (2007). "Management of small cell lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition)". Chest. 132 (3 Suppl): 324S–339S. doi:10.1378/chest.07-1385. PMID 17873178.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Goldstein, SD (2011). "Role of surgery in small cell lung cancer". Surgical Oncology Clinics of North America. 20 (4): 769–777. doi:10.1016/j.soc.2011.08.001. PMID 21986271.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Arriagada, R (2002). Oxford Textbook of Oncology (2nd ed.). Oxford University Press. p. 2094. ISBN 0-19-262926-3.
{{cite book}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Hatton, MQ (2010). "Continuous hyperfractionated accelerated radiotherapy (CHART) and non-conventionally fractionated radiotherapy in the treatment of non-small cell lung cancer: a review and consideration of future directions". Clinical Oncology (Royal College of Radiologists). 22 (5): 356–364. doi:10.1016/j.clon.2010.03.010. PMID 20399629.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ PORT Meta-analysis Trialists Group (2005). Rydzewska, Larysa (ed.). "Postoperative radiotherapy for non-small cell lung cancer". Cochrane Database of Systematic Reviews (2): CD002142. doi:10.1002/14651858.CD002142.pub2. PMID 15846628.
- ^ Le Péchoux, C (2011). "Role of postoperative radiotherapy in resected non-small cell lung cancer: a reassessment based on new data". Oncologist. 16 (5): 672–681. doi:10.1634/theoncologist.2010-0150. PMC 3228187. PMID 21378080.
- ^ Cardona, AF (2008). "Palliative endobronchial brachytherapy for non-small cell lung cancer". Cochrane Database of Systematic Reviews (2): CD004284. doi:10.1002/14651858.CD004284.pub2. PMID 18425900.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Ikushima, H (2010). "Radiation therapy: state of the art and the future". Journal of Medical Investigation. 57 (1–2): 1–11. PMID 20299738.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Paumier, A (2011). "Prophylactic cranial irradiation in lung cancer". Cancer Treatment Reviews. 37 (4): 261–265. doi:10.1016/j.ctrv.2010.08.009. PMID 20934256.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Girard, N (2011). "Stereotactic radiotherapy for non-small cell lung cancer: From concept to clinical reality. 2011 update". Cancer Radiothérapie. 15 (6–7): 522–526. doi:10.1016/j.canrad.2011.07.241. PMID 21889901.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Fairchild, A (2008). "Palliative thoracic radiotherapy for lung cancer: a systematic review". Journal of Clinical Oncology. 26 (24): 4001–4011. doi:10.1200/JCO.2007.15.3312. PMID 18711191.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Hann CL, Rudin CM (2008-11-30). "Management of small-cell lung cancer: incremental changes but hope for the future". Oncology (Williston Park). 22 (13): 1486–92. PMID 19133604.
- ^ Murray, N (2006). "A review of first-line treatment for small-cell lung cancer". Journal of Thoracic Oncology. 1 (3): 270–278. PMID 17409868.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Azim, HA (2007). "Treatment options for relapsed small-cell lung cancer". Anticancer drugs. 18 (3): 255–261. doi:10.1097/CAD.0b013e328011a547. PMID 17264756.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ MacCallum, C (2006). "Second-line treatment of small-cell lung cancer". Current Oncology Reports. 8 (4): 258–264. doi:10.1007/s11912-006-0030-8. PMID 17254525.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b NSCLC Meta-Analyses Collaborative Group (2008). "Chemotherapy in Addition to Supportive Care Improves Survival in Advanced Non–Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 16 Randomized Controlled Trials". J. Clin. Oncol. 26 (28): 4617–25. doi:10.1200/JCO.2008.17.7162. PMC 2653127. PMID 18678835.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Mehra R, Treat J (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 1876. ISBN 0-07-145739-9.
- ^ a b Clegg, A (2002). "Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine, and vinorelbine in non-small cell lung cancer: a systematic review". Thorax. 57 (1). BMJ Publishing Group: 20–28. doi:10.1136/thorax.57.1.20. PMC 1746188. PMID 11809985.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Fuld AD, Dragnev KH, Rigas JR (2010). "Pemetrexed in advanced non-small-cell lung cancer". Expert Opin Pharmacother. 11 (8): 1387–402. doi:10.1517/14656566.2010.482560. PMID 20446853.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) - ^ Carbone, DP (2011). "Adjuvant therapy in non-small cell lung cancer: future treatment prospects and paradigms". Clinical Lung Cancer. 12 (5): 261–271. doi:10.1016/j.cllc.2011.06.002. PMID 21831720.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b Le Chevalier, T (2010). "Adjuvant chemotherapy for resectable non-small-cell lung cancer: where is it going?". Annals of Oncology. 21 (Suppl. 7): vii196–198. doi:10.1093/annonc/mdq376. PMID 20943614.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Horn, L (2007). "The rationale for adjuvant chemotherapy in stage I non-small cell lung cancer". Journal of Thoracic Oncology. 2 (5): 377–383. doi:10.1097/01.JTO.0000268669.64625.bb. PMID 17473651.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Wakelee, HA (2006). "Current status of adjuvant chemotherapy for stage IB non-small-cell lung cancer: implications for the New Intergroup Trial". Clinical Lung Cancer. 8 (1). Cancer Information Group: 18–21. doi:10.3816/CLC.2006.n.028. PMID 16870041.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ BMJ (2005). Clinical evidence concise : the international resource of the best available evidence for effective health care. London: BMJ Publishing Group. pp. 486–488. ISBN 1-905545-00-2. ISSN 1475-9225.
{{cite book}}
: Unknown parameter|month=
ignored (help) - ^ Kelley AS, Meier DE (2010). "Palliative care—a shifting paradigm". New England Journal of Medicine. 363 (8): 781–2. doi:10.1056/NEJMe1004139. PMID 20818881.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ a b Prince-Paul M (2009). "When hospice is the best option: an opportunity to redefine goals". Oncology (Williston Park, N.Y.). 23 (4 Suppl Nurse Ed): 13–7. PMID 19856592.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Souquet PJ, Chauvin F, Boissel JP, Bernard JP (1995). "Meta-analysis of randomised trials of systemic chemotherapy versus supportive treatment in non-resectable non-small cell lung cancer". Lung Cancer. 12 Suppl 1: S147–54. doi:10.1016/0169-5002(95)00430-9. PMID 7551923.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) - ^ Sörenson S, Glimelius B, Nygren P (2001). "A systematic overview of chemotherapy effects in non-small cell lung cancer". Acta Oncol. 40 (2–3): 327–39. PMID 11441939.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Clegg A, Scott DA, Sidhu M, Hewitson P, Waugh N (2001). "A rapid and systematic review of the clinical effectiveness and cost-effectiveness of paclitaxel, docetaxel, gemcitabine and vinorelbine in non-small-cell lung cancer". Health Technol Assess. 5 (32): 1–195. PMID 12065068.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Template:Cite Cochrane
- ^ "Non-Small Cell Lung Cancer Treatment". PDQ for Health Professionals. National Cancer Institute. Retrieved 2008-11-22.
- ^ "Small Cell Lung Cancer Treatment". PDQ for Health Professionals. National Cancer Institute. 2012. Retrieved 2012-05-16.
- ^ Spiro, SG (2010). "18.19.1". Oxford Textbook Medicine (5th ed.). OUP Oxford. ISBN 978-0199204854.
- ^ SEER data (SEER.cancer.gov) Median Age of Cancer Patients at Diagnosis 2002-2003
- ^ SEER data (SEER.cancer.gov) Median Age of Cancer Patients at Death 2002-2006
- ^ Slatore, CG (November 2010). "An official American Thoracic Society systematic review: insurance status and disparities in lung cancer practices and outcomes". American Journal of Respiratory and Critical Care Medicine. 182 (9): 1195–1205. doi:10.1164/rccm.2009-038ST. PMID 21041563.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ "WHO Disease and injury country estimates". World Health Organization. 2009. Retrieved November 11, 2009.
- ^ Jemal A, Tiwari RC, Murray T; et al. (2004). "Cancer statistics, 2004". CA: a Cancer Journal for Clinicians. 54 (1): 8–29. doi:10.3322/canjclin.54.1.8. PMID 14974761.
{{cite journal}}
: Explicit use of et al. in:|author=
(help)CS1 maint: multiple names: authors list (link) - ^ Proctor, RN (2012). "The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll". Tobacco Control. 21 (2): 87–91. doi:10.1136/tobaccocontrol-2011-050338. PMID 22345227.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Lum, KL (2008). "Signed, sealed and delivered: "big tobacco" in Hollywood, 1927–1951". Tobacco Control. 17 (5): 313–323. doi:10.1136/tc.2008.025445. PMC 2602591. PMID 18818225.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Lovato, C (October 2011). "Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours". Cochrane Database of Systematic Reviews (10): CD003439. doi:10.1002/14651858.CD003439.pub2. PMID 21975739.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Kemp, FB (2009). "Smoke free policies in Europe. An overview". Pneumologia. 58 (3): 155–158. PMID 19817310.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ National Cancer Institute; SEER stat fact sheets: Lung and Bronchus. Surveillance Epidemiology and End Results. 2010 [1]
- ^ "Gender in lung cancer and smoking research" (PDF). World Health Organization. 2004. Retrieved 2007-05-26.
- ^ Zhang, J (November 2011). "Tobacco smoking in China: prevalence, disease burden, challenges and future strategies". Respirology. 16 (8): 1165–1172. doi:10.1111/j.1440-1843.2011.02062.x. PMID 21910781.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Behera, D (2004). "Lung cancer in India" (PDF). Indian Journal of Chest Diseases and Allied Sciences. 46 (4): 269–281. PMID 15515828.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help) - ^ Charloux, A (1997). "The increasing incidence of lung adenocarcinoma: reality or artefact? A review of the epidemiology of lung adenocarcinoma". International Journal of Epidemiology. 26 (1): 14–23. doi:10.1093/ije/26.1.14. PMID 9126499.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Kadara, H (2012). "Pulmonary adenocarcinoma: a renewed entity in 2011". Respirology. 17 (1): 50–65. doi:10.1111/j.1440-1843.2011.02095.x. PMID 22040022.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Morgagni, Giovanni Battista (1761). De sedibus et causis morborum per anatomen indagatis. OL 24830495M.
- ^ Bayle, Gaspard-Laurent (1810). Recherches sur la phthisie pulmonaire (in French). Paris. OL 15355651W.
- ^ a b Witschi, H (2001). "A short history of lung cancer". Toxicological Sciences. 64 (1): 4–6. doi:10.1093/toxsci/64.1.4. PMID 11606795.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Adler, I (1912). Primary Malignant Growths of the Lungs and Bronchi. New York: Longmans, Green, and Company. OCLC 14783544. OL 24396062M., cited in Spiro SG, Silvestri GA (2005). "One hundred years of lung cancer". American Journal of Respiratory and Critical Care Medicine. 172 (5): 523–529. doi:10.1164/rccm.200504-531OE. PMID 15961694.
- ^ Grannis, FW. "History of cigarette smoking and lung cancer". smokinglungs.com. Archived from the original on July 18, 2007. Retrieved 2007-08-06.
- ^ Proctor, R (2000). The Nazi War on Cancer. Princeton University Press. pp. 173–246. ISBN 0-691-00196-0.
- ^ Doll, R (1956). "Lung Cancer and Other Causes of Death in Relation to Smoking". British Medical Journal. 2 (5001): 1071–1081. doi:10.1136/bmj.2.5001.1071. PMC 2035864. PMID 13364389.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ US Department of Health Education and Welfare (1964). "Smoking and health: report of the advisory committee to the Surgeon General of the Public Health Service" (PDF). Washington, DC: US Government Printing Office.
- ^ a b Greaves, M (2000). Cancer: the Evolutionary Legacy. Oxford University Press. pp. 196–197. ISBN 0-19-262835-6.
- ^ Greenberg, M (1993). "Lung cancer in the Schneeberg mines: a reappraisal of the data reported by Harting and Hesse in 1879". Annals of Occupational Hygiene. 37 (1): 5–14. PMID 8460878.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Samet, JM (2011). "Radiation and cancer risk: a continuing challenge for epidemiologists". Environmental Health. 10 (Suppl. 1): S4. doi:10.1186/1476-069X-10-S1-S4. PMC 3073196. PMID 21489214.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: unflagged free DOI (link) - ^ Horn, L (2008). "Evarts A. Graham and the first pneumonectomy for lung cancer". Journal of Clinical Oncology. 26 (19): 3268–3275. doi:10.1200/JCO.2008.16.8260. PMID 18591561.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Edwards, AT (1946). "Carcinoma of the Bronchus". Thorax. 1 (1): 1–25. doi:10.1136/thx.1.1.1. PMC 1018207. PMID 20986395.
- ^ Kabela, M (1956). "Erfahrungen mit der radikalen Röntgenbestrahlung des Bronchienkrebses". Ceskoslovenská Onkológia (in German). 3 (2): 109–115. PMID 13383622.
{{cite journal}}
: Unknown parameter|trans_title=
ignored (|trans-title=
suggested) (help) - ^ Saunders, M (1997). "Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial". Lancet. 350 (9072). Elsevier: 161–165. doi:10.1016/S0140-6736(97)06305-8. PMID 9250182.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Lennox, SC (1968). "Results of resection for oat-cell carcinoma of the lung". Lancet. 2 (7575). Elsevier: 925–927. doi:10.1016/S0140-6736(68)91163-X. PMID 4176258.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Miller, AB (1969). "Five-year follow-up of the Medical Research Council comparative trial of surgery and radiotherapy for the primary treatment of small-celled or oat-celled carcinoma of the bronchus". Lancet. 2 (7619). Elsevier: 501–505. doi:10.1016/S0140-6736(69)90212-8. PMID 4184834.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help); Unknown parameter|month=
ignored (help) - ^ Cohen, M (1977). "Intensive chemotherapy of small cell bronchogenic carcinoma". Cancer Treatment Reports. 61 (3): 349–354. PMID 194691.
{{cite journal}}
: Unknown parameter|coauthors=
ignored (|author=
suggested) (help)
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