Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- 32 Sinonasal
- 33 Larynx
- 34 Bronchus and lung
- 35 Pleura/mesothelioma
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
34 - Bronchus and lung
Published online by Cambridge University Press: 03 May 2010
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- 32 Sinonasal
- 33 Larynx
- 34 Bronchus and lung
- 35 Pleura/mesothelioma
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
Summary
Introduction
Beginning in mid-century, a pandemic of lung cancer affected the industrial countries of Europe and North America, later spreading to nearly all other nations. This was due to the increasing widespread use of tobacco.
Histology, classification and diagnosis
Lung cancer can be classified into four major histological types, which have been shown to have etiological significance (IARC, 1988). As interpretation of epidemiological findings has been hampered by variations in nomenclature and criteria, the WHO Classification should be followed (Table 34.1).
The association with cigarette smoking is strongest for squamous cell carcinoma (and its variants), and least for adenocarcinoma. The proportion of the histological types changes according to sex and age group. It is also influenced by the source of biopsy, since peripheral tumors are more likely to be adenocarcinomas. There is evidence that the small (oat) cell type of carcinoma is a biological entity associated with the ras oncogene, and possibly a human papilloma virus (HPV).
Descriptive epidemiology
Incidence
Large international variations are seen (Fig. 34.1 and Appendix 1). In 1980, lung cancer was globally estimated to comprise one in ten of all newly diagnosed cancers for both sexes combined and was the most common tumor in males. The highest rates (100 to 110) are observed in the US black population, in New Zealand Maoris and in Scotland.
- Type
- Chapter
- Information
- Human CancerEpidemiology and Environmental Causes, pp. 333 - 345Publisher: Cambridge University PressPrint publication year: 1992