Despite innovative advances in understanding the genetics of lung cancer, potential risk factors, and the immune system’s role in lung cancer control, as well as the development of targeted therapies, lung cancer remains the leading cause of cancer mortality in both men and women, with industrialized regions such as North America and Europe reporting the greatest rates of incidence.
Lung cancer is more common in men than in women and occurs predominately in individuals aged 50 to 70 years. In both sexes, the possibility of developing lung cancer remains very low until age 39 years, after which it begins to increase, and peaks among individuals older than age 70 years. In 2021, lung cancer occurred in approximately 2 million patients and contributed to an estimated 1.8 million deaths globally. According to estimates from the American Cancer Society (ACS), projections for lung cancer in the United States in 2022 are as follows:
• Approximately 236,740 new cases of lung cancer (117,910 in men and 118,830 in women), with a new diagnosis every 2.2 minutes
• Approximately 130,180 deaths from lung cancer (68,820 in men and 61,360 in women).
Lung cancer is the second most commonly diagnosed cancer worldwide (after breast cancer), and its incidence continues to grow. Since 1987, lung cancer has been recognized as one of the leading causes of cancer mortality among women, accounting for an estimated 1.4 times more deaths than breast cancer. The risk of developing lung cancer remains higher among men in all age groups after age 40 years. The ACS also states that lung cancer accounts for nearly 25% of all cancer deaths, and annually more individuals die from lung cancer than from the three most common cancers (colon, breast, and prostate) combined.
According to the National Cancer Institute (NCI), one in 16 persons in the U.S. will be diagnosed with lung cancer in his or her lifetime. The NCI also notes that while lung cancer accounts for 12% of all new cancer diagnoses, it is responsible for 22% of all cancer deaths. The ACS estimates that the probability that a man will develop lung cancer in his lifetime is about one in 15; for a woman, the risk is about one in 17. These figures include both individuals who smoke and those who do not smoke, but for persons who smoke, the risk is much greater for those who do not smoke. The ACS also notes the following:
• African American men are approximately 12% more likely than Caucasian men to develop lung cancer, and the rate is estimated to be roughly 16% lower in African American women than in Caucasian women
• Although both African American women and Caucasian women have lower rates than men, the gap is closing, and the lung cancer rates have been declining among men over the past few decades (but only for about the last decade in women)
• Despite their overall risk of lung cancer being greater, African American men are less likely than Caucasian men to develop small cell lung cancer (SCLC).
Nearly 65% of all new lung cancer cases occur in individuals who have never smoked or are former smokers. Moreover, an estimated 12% of new cases are in those who have never smoked. The ACS indicates that the 5-year relative survival rate for lung cancer is 22% overall (18% for men and 25% for women); 26% for non–small cell lung cancer; and 7% for SCLC. Only 24% of lung cancers are diagnosed at a localized stage, for which the 5-year survival rate is 60%
In the U.S., lung cancer death rates have been declining at an accelerated rate, and from 2014 to 2018, mortality rates diminished by more than 5% per year in men and 4% per year in women.
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