EPIDEMIOLOGY OF LUNG CANCER

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HISTOLOGY

Lung cancer is a broad term for cancers that arise in epithelial tissue in the lining of the bronchi, but also in the trachea, bronchioles, and alveoli. The histologic classification recommended by the World Health Organization (WHO) in 1981 is most commonly used.43 Histologically, about 20% of all cases are small-cell lung cancers, also known as oat cell carcinoma, and about 80% are non–small cell lung cancers (NSCLC), with the NSCLCs divided into three subtypes: (1) large cell

International Trends

The most recent data for examining the worldwide disease burden from lung cancer are from 1990.60* Cancer of the lung is now the most frequently occurring cancer in the world, and the leading cause of cancer mortality.9, 60 In 1990, an estimated 1.04 million

RISK FACTORS

Lung cancer is unique among all malignancies in having a single risk factor that accounts for a high percentage of the attributable risk. Tobacco smoking, mainly cigarettes, accounts for approximately 90% of lung cancer risk.85 Other risks, both known and hypothesized, include exposure to certain industrial substances, such as arsenic; some organic chemicals; radon and asbestos, particularly among smokers; radiation exposure from occupational, medical, and environmental sources; pollutants in

SUMMARY

There are few relationships in the epidemiology of cancer between an exposure and disease that are as consistent as those observed between tobacco and lung cancer. The health consequences of tobacco use are not limited to lung cancer; the 1990 Surgeon General's Report described that the use of cigarettes was the leading cause of avoidable mortality in the United States, with about 434,000 preventable deaths per year.84 Although a majority of the adults in the United States are current or former

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    Address reprint requests to Robert A. Smith, PhD, American Cancer Society, 1599 Clifton Road, NE, Atlanta, GA 30329, e-mail: [email protected]

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    American Cancer Society, Atlanta, Georgia

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