Epidemiology of lung cancer

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.

Keywords: aetiology; epidemiology; incidence; lung cancer; mortality; risk factors; survival; trends.

Fig. 1

Map showing estimated age-standardized incidence rates for lung cancer worldwide in 2018, in both sexes including all ages. Created with mapchart.net. Data obtained from Globocan 2018 [5]

Fig. 2

Map showing estimated age-standardized mortality rates for lung cancer worldwide in 2018, in both sexes including all ages. Created with mapchart.net. Data obtained from Globocan 2018 [5]

Fig. 3

Bar chart showing estimated age-standardized incidence and mortality rates (World) in 2018, lung, both sexes, all ages. Data obtained from Globocan 2018 [5]

Fig. 4

Lung and bronchus cancer recent trends in SEER relative survival rates, 2000–2016 by sex, all races (includes Hispanic), all ages, all stages, 5 years [6]