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Epidemiology of Lung Cancer^*

ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)

^* From the Hollings Cancer Center (Dr. Alberg), Medical University of South Carolina, Charleston, SC; and Department of Epidemiology (Drs. Alberg, Ford, and Samet), Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.

Correspondence to: Anthony J. Alberg, PhD, MPH, Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas St, PO Box 250955, Charleston, SC 29425; e-mail: alberg{at}musc.edu

Background: The objective of this study was to summarize the published literature concerning the epidemiology of lung cancer.

Methods: A narrative review of published evidence was conducted, identifying and summarizing key reports that describe the occurrence of lung cancer in populations and factors that affect lung cancer risk.

Results: In the United States, lung cancer remains the leading cause of cancer death in both men and women, even though an extensive list of modifiable risk factors has long been identified. The predominant cause of lung cancer is exposure to tobacco smoke, with active smoking causing most cases but passive smoking also contributing to the lung cancer burden.

Conclusions: The reductions in smoking prevalence in men that occurred in the late 1960s through the 1980s will continue to drive lung cancer mortality rates downward in men during the first portion of this century, but rates in women have not yet begun to decrease. Fortunately, exposures to major occupational respiratory carcinogens have largely been controlled, but the population is still exposed to environmental causes of lung cancer, including radon, the second leading cause of lung cancer death.

Key Words: air pollution • asbestos • cigarette smoking • epidemiology • lung cancer • nutrition • occupation • passive smoking • radiation • tobacco

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