Epidemiology of lung cancer: looking to the future

Our plain-English summary of Epidemiology of lung cancer: looking to the future, by A.J. Alberg, M.V. Brock, J.M. Samet (Journal of Clinical Oncology, 2005).

The study

• Authors: A.J. Alberg, M.V. Brock, J.M. Samet
• Journal: Journal of Clinical Oncology
• Published: 2005;23(14):3175-85
• Type of article: Review
• Cited by: 319 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In the United States, the 20th century witnessed the emergence of a lung cancer epidemic that peaked and began to decline by the century's end, a decline that continues today. However, lung cancer continues to be an unabating pandemic. In research carried out over the last half of the 20th century, many factors were causally associated with lung cancer and studies were implemented to identify determinants of susceptibility to these factors. Cigarette smoking was identified as the single most predominant cause of the lung cancer epidemic, but other causes were found, including workplace agents (eg, asbestos, arsenic, chromium, nickel, and radon) and other environmental factors (passive smoking, indoor radon, and air pollution). Contemporary epidemiologic research on lung cancer now focuses on a new set of issues, primarily related to susceptibility to the well-identified causal factors, particularly smoking, and on the consequences of changes in tobacco products for risks to smokers. Diet and the possibility of reducing risk through chemoprevention remain a focus of research emphasis through experimental and observational approaches. Questions have also been raised about possible differences in susceptibility to lung cancer by sex and race. Population patterns in smoking prevalence will continue to be the most powerful predictor of the future occurrence of lung cancer. Evaluation of recent US patterns in smoking prevalence indicates that for the next approximately 10 to 15 years, lung cancer rates will decrease, but will then level off starting in approximately 2030. Unless further reductions in the prevalence of cigarette smoking are achieved over the next decade, lung cancer will remain as an all too common, but avoidable, disease.

In plain English

This article was a review, not a new study. The authors surveyed published research on the epidemiology of lung cancer, mainly in the United States. They discussed what they saw as active research areas: changing types of lung tumors, differences by race, income and sex, diet, molecular changes in lung tissue, and inherited susceptibility. Cigarette smoking was the central theme, and asbestos received only brief mention. The authors wrote that workplace exposures of earlier decades, particularly widespread asbestos exposure in the 1940s through the 1960s, still contributed to the current burden of lung cancer, although that contribution was relatively small compared with cigarette smoking. Citing another study, they noted that mesothelioma incidence among men had begun to decline, consistent with controls on workplace asbestos exposure. Based on US smoking patterns, the authors projected that lung cancer death rates would keep falling until about 2020 and then remain constant. The article's abstract gives about 2030 for the leveling off. The authors concluded that unless smoking declined further, lung cancer would remain a common but avoidable disease.

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: narrative review of published epidemiologic research on lung cancer; no new data
• Who was studied: No study population of its own; the review drew on published research and statistics, mostly from the United States
• Exposure: Mainly cigarette smoking. Workplace agents including asbestos (no fiber type specified), arsenic, chromium, nickel and radon were also mentioned, as were diet and genetic factors
• Main results:
  • The authors wrote that workplace exposures of earlier decades, particularly widespread asbestos exposure in the 1940s through the 1960s, contribute to the current burden of lung cancer
  • The authors described this workplace contribution to overall lung cancer rates as relatively small compared with cigarette smoking
  • Citing another study (reference 13), the authors noted that mesothelioma incidence among men had begun to decline, consistent with workplace asbestos controls
  • The authors projected from US smoking patterns that lung cancer death rates would decrease until about 2020 and then remain constant, assuming a roughly 30-year lag
  • Citing national cancer statistics for 1997 to 2001, lung cancer incidence was 26% higher in black men than in white men in the NPCR/SEER data (109.0 vs 86.8 per 100,000 per year) and 36% higher in the SEER data alone (104.1 vs 76.6 per 100,000 per year)
  • Citing another source (reference 101), the review stated that a smoker's absolute lifetime risk of developing lung cancer is approximately 10% to 20%
• The authors' conclusion: The authors concluded that unless smoking prevalence falls further over the next decade, lung cancer will remain a common but avoidable disease

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Epidemiology, Lung Cancer.

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Browse more research in Journal of Clinical Oncology, or return to medical research.