Epidemiology, etiology, and prevention of lung cancer

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Worldwide Trends

Lung cancer is the leading cause of cancer death in the world. In 1990, the most recent year for which data are available, there were estimated to be slightly more than 1 million cases of lung cancer worldwide and almost 1 million lung cancer deaths.86, 90 Lung cancer accounted for 12.8% of the total cases of cancer worldwide and 17.8% of the cancer deaths.86 Lung cancer is a highly lethal disease, with similar incidence and mortality rates. Most patients who develop lung cancer die of it, and

CAUSE

Tobacco use, especially cigarette smoking, accounts for up to 90% of all lung cancer deaths worldwide.104, 134 Fewer than 20% of cigarette smokers, however, develop lung cancer, suggesting that other factors play a role in the disease.137 Other causes of lung cancer include environmental factors, such as tobacco smoke, radon, and various occupational exposures. Diet and pre-existent nonmalignant lung disease also have been associated with the risk for developing lung cancer.

Diet

Several epidemiologic studies have shown an association between dietary intake of fruits and vegetables and reduced risk for lung cancer.55, 92 Based on these findings and results of basic science research, β-carotene (a precursor to the class of retinoids that includes vitamin A) was hypothesized to be the protective agent.92 This hypothesis was demonstrated convincingly in the Western Electric Study, in which, after 19 years of follow-up, it was shown that persons with the lowest intake of

SUMMARY

Over the past century, lung cancer has gone from an obscure disease to the leading cause of cancer death worldwide. Initially an epidemic disease among men in industrialized nations, lung cancer now has become the leading cancer killer in both sexes in the United States and an increasingly common disease of both sexes in developing countries. Lung cancer incidence largely mirrors smoking prevalence, with a latency period of several decades. Other important risk factors for the development of

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