Geographic differences in lung cancer: focus on carcinogens, genetic predisposition, and molecular epidemiology

Abstract

Lung cancer poses a global health challenge and stands as the leading cause of cancer-related deaths worldwide. However, its incidence, mortality, and characteristics are not uniform across all regions worldwide. Understanding the factors contributing to this diversity is crucial in a prevalent disease where most cases are diagnosed in advanced stages. Hence, prevention and early diagnosis emerge as the most efficient strategies to enhance outcomes. In Western societies, tobacco consumption constitutes the primary risk factor for lung cancer, accounting for up to 90% of cases. In other geographic locations, different significant factors play a fundamental role in disease development, such as individual genetic predisposition, or exposure to other carcinogens such as radon gas, environmental pollution, occupational exposures, or specific infectious diseases. Comprehensive clinical and molecular characterization of lung cancer in recent decades has enabled us to distinguish different subtypes of lung cancer with distinct phenotypes, genotypes, immunogenicity, treatment responses, and survival rates. The ultimate goal is to prevent and individualize lung cancer management in each community and improve patient outcomes.

Keywords: NSCLC; geographic differences; molecular diagnosis; molecular epidemiology.

Figure 1.

Distribution of the main actionable genomic alterations in non-small-cell lung cancer across the five continents. The gray proportion of each sector graphic represents ‘non-reported’ molecular information. Studies used for collecting the prevalence of each alteration are represented in Supplemental Table 1S.