Epidemiology of lung cancer

Our plain-English summary of Epidemiology of lung cancer, by K.C. Thandra, A. Barsouk, K. Saginala, et al (Contemporary Oncology = Współczesna Onkologia, 2021).

The study

• Authors: K.C. Thandra, A. Barsouk, K. Saginala, J.S. Aluru, A. Barsouk
• Journal: Contemporary Oncology = Współczesna Onkologia
• Published: 2021;25(1):45-52
• Type of article: Review
• Cited by: 686 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Lung cancer is the leading cause of global cancer incidence and mortality, accounting for an estimated 2 million diagnoses and 1.8 million deaths. Neoplasms of the lungs are the second most common cancer diagnosis in men and women (after prostate and breast cancer, respectively). With increasing access to tobacco and industrialization in developing nations, lung cancer incidence is rising globally. The average age of diagnosis is 70 years old. Men are twice as likely to be diagnosed with lung cancer, which largely reflects differences in tobacco consumption, although women may be more susceptible due to higher proportions of epidermal growth factor receptor mutations and the effects of oestrogen. African American men in the US are at the highest risk of lung cancer. Family history increases risk by 1.7-fold, with a greater risk among first-degree relatives. Tobacco smoking is the greatest preventable cause of death worldwide, accounting for up to 90% of lung cancer cases, and continued consumption is projected to increase global cancer incidence, particularly in developing nations such as China, Russia, and India. Second-hand smoke among children and spouses has likewise been implicated. Radon from natural underground uranium decay is the second leading cause of lung cancer in the developed world. Occupational hazards such as asbestos and environmental exposures such as air pollution, arsenic, and HIV and Tb infection have all been implicated in lung carcinogenesis, while cannabis smoking, electronic cigarettes, heated tobacco products, and COVID-19 have been hypothesized to increase risk.

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In plain English

This article is a review, not a new study. The authors summarized published statistics and research on lung cancer incidence, deaths, survival and risk factors worldwide. Citing GLOBOCAN estimates, they reported 2,094,000 new lung cancer cases and an estimated 1,761,000 deaths worldwide in 2018. Citing US data, they reported a 5-year survival rate of 20.5% for 2010–2016. They wrote that more than 80% of lung cancer cases in the Western world are attributable to cigarette smoking, and that residential radon accounts for an estimated 10% of cases there. On asbestos, the review stated that occupational carcinogens are estimated to account for 5–10% of global lung cancer cases, with asbestos the most common contributor. Citing a North American cohort of insulators, it reported that lung cancer among non-smokers was increased 3.5 fold. It also reported that a cohort study found a 14.4-fold increased risk, which it linked to the synergistic effect of asbestos with smoking. The authors concluded that the global burden of lung cancer is projected to rise with increasing tobacco-smoking rates, and listed asbestos among further major contributors.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review paper (narrative review of published statistics and studies on lung cancer epidemiology and risk factors)
• Who was studied: No study population of its own. The review covered lung cancer worldwide, drawing on GLOBOCAN 2018 estimates, US SEER data and published studies.
• Exposure: Many risk factors were reviewed: tobacco smoking, second-hand smoke, e-cigarettes, cannabis, asbestos, radon, air pollution, arsenic, infections and COPD. Asbestos is discussed only as 'asbestos'. No fiber types are named.
• Main results:
  • Worldwide in 2018, citing GLOBOCAN: an estimated 1,761,000 lung cancer deaths, 18.4% of all cancer deaths.
  • US, citing SEER: the latest 5-year survival rate for lung cancer (2010–2016) was 20.5%.
  • The review stated that more than 80% of lung cancer cases in the Western world are attributable to cigarette smoking.
  • Citing a North American cohort of insulators (who regularly worked with asbestos), the review reported that the rate of lung cancer among non-smokers was increased 3.5 fold.
  • The review described a synergistic effect of asbestos with tobacco smoking on lung cancer, citing a cohort study that reported a 14.4-fold increased risk.
  • The review stated that asbestos use is highly regulated in the Western world but increasing in developing nations such as Asia and Latin America (the article's wording).
  • Residential radon exposure was described as the second greatest risk factor for lung cancer in the Western world, accounting for an estimated 10% of cases.
• The authors' conclusion: The authors concluded that lung cancer is the most common and deadly cancer worldwide and that its global burden is projected to rise with increasing tobacco-smoking rates. They listed radon, second-hand smoke, asbestos, air pollution, arsenic, and HIV and TB infection as further major contributors.

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Lung Cancer, Neoplasm, Environmental Exposure, Carcinogenesis.

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