The International Epidemiology of Lung Cancer: Latest Trends, Disparities, and Tumor Characteristics

Abstract

Introduction: Our aim was to update global lung cancer epidemiology and describe changing trends and disparities.

Methods: We presented country-specific incidence and mortality from GLOBOCAN 2012 by region and socioeconomic factors via the Human Development Index (HDI). Between- and within-country incidence by histological type was analyzed by using International Agency for Research on Cancer data on cancer incidence on five continents. Trend analyses including data from the International Agency for Research on Cancer, cancer registries, and the WHO mortality database were conducted using joinpoint regression. Survival was compared between and within countries and by histological type.

Results: In 2012, there were 1.82 and 1.59 million new lung cancer cases and deaths worldwide, respectively. Incidence was highest in countries with a very high HDI and lowest in countries with a low HDI (42.2 versus 7.9 in 100,000 for males and 21.8 versus 3.1 in 100,000 for females, respectively). In most countries with a very high HDI, as incidence in males decreased gradually (ranging from -0.3% in Spain to -2.5% in the United States each year), incidence in females continued to increase (with the increase ranging from 1.4% each year in Australia to 6.1% in recent years in Spain). Although histological type varied between countries, adenocarcinoma was more common than squamous cell carcinoma, particularly among females (e.g., in Chinese females, the adenocarcinoma-to-squamous cell carcinoma ratio was 6.6). Five-year relative survival varied from 2% (Libya) to 30% (Japan), with substantial within-country differences.

Conclusions: Lung cancer will continue to be a major health problem well through the first half of this century. Preventive strategies, particularly tobacco control, tailored to populations at highest risk are key to reducing the global burden of lung cancer.

Keywords: Disparity; Epidemiology; Histological type; International; Lung cancer; Survival.

Figure 1

Lung cancer incidence rate trends by country, 1980–2011. A) Increasing trend in both sexes B) Male rates increase but female rates are relatively stable C) Stable trend in both sexes D) Male rates are relatively stable but females are decreasing E) Male rates decrease while female rates increase F) Decreasing trend in both sexes Data sources: Australian Institute of Health and Welfare (Australia), Hong Kong Cancer Registry (Hong Kong), National Cancer Registry Ireland (Ireland), National Cancer Center (Japan), Netherlands Comprehensive Cancer Organisation (Netherlands), National Board of Health and Welfare (Sweden), SEER-9 (USA), International Agency for Research on Cancer (all other countries). Notes: 1. y axis represents ‘Incidence rate per 100,000 population per year’ and is on the log scale, x axis represents ‘Year’. 2. Incidence rates have been age-standardized to the World Standard Population.^, 3. Trends calculated using Joinpoint software v4.0.4, National Cancer Institute. 4. Countries are grouped by their most recent trend.

Figure 2

Lung cancer mortality rate trends by country, 1980–2012. A) Increasing trend in both sexes B) Male rates are relatively stable but female rates are increasing C) Male rates decrease while female rates increase D) Male rates decrease while females are relatively stable E) Decreasing trend in both sexes Data source: World Health Organization. Notes: 1. y axis represents ‘Mortality rate per 100,000 population per year’ and is on the log scale, x axis represents ‘Year’. 2. Mortality rates have been age-standardized to the World Standard Population.^, 3. Trends calated using Joinpoint software v4.0.4, National Cancer Institute. 4. Countries are grouped by their most recent trend.