Non-small Cell Lung Cancer

Incidence and mortality

At the start of the millennium, it was estimated that there were 10 million new cancer cases worldwide per annum and of these the most common were cancers of the trachea, bronchus and lung, which together accounted for 12.7%.¹ By comparison, cancer of the stomach, the liver and the colon and rectum accounted for 10.2%, 10.0% and 9.5%, respectively. In the year 2000, more than 7 million deaths were attributable to cancer (13% of worldwide mortality from all causes) and lung cancer, along with tumours of the trachea and bronchus, was by far the most common accounting for 17.2% of all cancer deaths.^1,2

In the United States (US) it is estimated that there will be 173,770 new cases of lung and bronchus cancer in the year 2004.³ Only prostate cancer (230,110) and breast cancer (217,440) are estimated to have a greater incidence. However, advances in the detection and treatment of prostate and breast cancers means that the number of related deaths will represent a small proportion of the overall incidence (prostate 29,900 [13%]; breast 40,580 [19%]). The same cannot be said for lung cancer where it is estimated that the number of related deaths will exceed 160,000 or 92% of the incidence rate. Accordingly, cancer of the lung (and bronchus) is estimated to be the leading cause of cancer death in both men (32% of all cancer deaths) and women (25% of all cancer deaths) in the US in 2004. The number of total cancer deaths for men in the US has been stable between 1995 and 2000, but has increased for women by 0.4% per annum between 1987 and 2000. This is in agreement with an increase of 0.6% per annum in lung and bronchus cancer-related deaths in American women in the period 1992–2000.³

The picture in Europe differs from that in the US. In 1995, lung cancer was the most prevalent newly diagnosed cancer (377,000) followed by colorectal (334,000) and female breast (321,000).4 However, as in the US, lung cancer was associated with the highest mortality being attributed to the deaths of 330,000 people or one-fifth of all cancer deaths. This was followed by colorectal (189,000) and stomach cancer (152,000). The relationship between lung cancer and gender is heterogeneous in Europe and this reflects the past smoking habits of the diverse cultures within the region.⁵ In 1995, lung cancer accounted for 29% of all cancer deaths in men and 9% in women.4 Projections indicate that notwithstanding local variations, lung cancer deaths in Europe are generally declining in men but increasing in younger and older women in almost all countries within the European Union.^4–6

Whilst mortality from lung cancer is set to peak (in women) or indeed decline (in men) over the next decade in the developed countries, there is a clear upward trend for all cancers including lung in developing countries such as India, China and much of northern Asia.^1,7

NSCLC

• Incidence and Mortality
• Causes
• Risk Factors
• Histology/Pathology
• Disease Staging/Prognosis
• Signs and Symptoms
• Diagnosis