Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Most forms of lung cancer fall within one of four categories: squamous cell (or epidermoid) carcinomas and adenocarcinomas (each of which accounts for approximately 30 percent of all pulmonary cancers), small or oat cell carcinomas (accounting for about 25 percent of lung cancers), and large cell carcinomas (which represent about 15 percent of lung cancers). Each of these forms can be further categorized on the basis of cell differentiation within the tumor: either well differentiated (resembling the original cell type) or moderately or poorly differentiated. Upon biopsy, stage groupings are also determined on the basis of size, invasiveness, and possible extent of metastasis.
Oat or small cell carcinomas usually consist of small, tightly packed, spindle-shaped cells, with a high nucleus-to-cytoplasm ratio within the cell. Oat cell carcinomas tend to metastasize early and widely, often to the bone marrow or brain. As a result, by the time that symptoms become apparent, the disease is generally widely disseminated within the body. Coupled with a resistance to most common forms of radiation and chemotherapy, oat cell carcinomas present a particularly poor prognosis. In general, patients diagnosed with this form of cancer have a survival period measured, at most, in months.
Adenocarcinomas are tumors of glandlike structure, presenting as nodules within peripheral tissue such as the bronchioles. Often these forms of...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
Diagnosis of a tumor in the lung generally includes a chest X ray, along with use of a variety of diagnostic tests: bronchography (X-ray observation of the bronchioles following application of an opaque material), tomography (cross-sectional observation of tissue), and cytologic examination of sputum or bronchiole washings. Confirmation of the diagnosis, in addition to determination of the specific type of tumor and its clinical stage, generally requires a needle biopsy of material from the lung.
The treatment of the tumor is dependent on the form of the disease and on the extent of its spread. Surgery remains the preferred method of treatment, but because of the nature of the disease, less than half the cases are operable at the time of diagnosis. Of these, a large proportion are beyond the point at which the surgical removal of the cancer and resection of remaining tissue are possible. A variety of chemotherapeutic measures are available and along with the use of radiation therapy can be used to produce a small number of cures or at least temporary alleviation of symptoms. Nevertheless, only a small proportion of lung cancers, perhaps 10 percent, respond with a permanent remission or cure.
Lung cancer represents the leading cause of cancer deaths among American men and women. In 2000, 164,000 new cases of lung cancer were reported, with 157,000 deaths reported. The prognosis for most forms of lung cancer...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Dollinger, Malin, et al. Everyone’s Guide to Cancer Therapy. 5th ed. Kansas City, Mo.: Andrews McMeel, 2008. A well-organized book on therapy for various cancers. Clearly describes the methods of treatment that are available and the treatment of choice. Written for the layperson.
Eyre, Harmon J., Dianne Partie Lange, and Lois B. Morris. Informed Decisions: The Complete Book of Cancer Diagnosis, Treatment, and Recovery. 2d ed. Atlanta: American Cancer Society, 2002. This text from the American Cancer Society is intended for the layperson. It is exemplary in its discussion of cancer.
Henschke, Claudia I. Lung Cancer: Myths, Facts, Choices—and Hope. New York: W. W. Norton, 2003. An award-winning book that describes how the lungs work and how cancer develops. Reviews why early detection is so critical, provides questionnaires to pinpoint risk factors, and addresses practical concerns such as dealing with insurance issues.
Lung Cancer Online Foundation. http://www.lung canceronline.org. A Web site that strives to improve the quality of care and quality of life for people with lung cancer by funding lung cancer research and providing information to patients and families.
Parles, Karen, and Joan H. Schiller. One Hundred Questions and Answers About Lung Cancer. 2d ed. Sudbury, Mass.: Jones and Bartlett, 2010. A patient-oriented guide that covers a range of topics...
(The entire section is 313 words.)
Lung Cancer (Encyclopedia of Alternative Medicine)
Lung cancer is a disease in which the cells of the lung tissues grow uncontrollably and form tumors. It is the leading cause of death from cancer among both men and women in the United States. The American Cancer Society (ACS) estimated that in 1998, at least 172,000 new cases of lung cancer were diagnosed, and that lung cancer accounted for 28% of all cancer deaths, or approximately 160,000 people. In 2002, the ACS reported that more than 150,000 Americans die from the disease every year. Only 15 percent of people with lung cancer will live five years.
Types of lung cancer
There are two kinds of lung cancers, primary and secondary. Primary lung cancer (also called adenocarcinoma) starts in the lung itself. Primary lung cancer is divided into small cell lung cancer and non-small cell lung cancer, depending on how the cells look under the microscope. Secondary lung cancer is cancer that starts somewhere else in the body (for example, the breast or colon) and spreads to the lungs.
Small cell cancer was formerly called oat cell cancer, because the cells resemble oats in their shape. About one-fourth of all lung cancers are small cell cancers. This type is a very aggressive cancer and spreads to other organs within a short time. It generally is found in...
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Lung Cancer (Encyclopedia of Nursing & Allied Health)
Lung cancer is a disease in which the cells of the lung tissues grow uncontrollably and form tumors. It is the leading cause of death from cancer among both men and women in the United States. The American Cancer Society estimates that in 2001 at least 169,500 new cases of lung cancer will be diagnosed, and that lung cancer will account for 28% of all cancer deathspproximately 157,400 people.
Types of lung cancer
There are two kinds of lung cancers, primary and secondary. Primary lung cancer starts in the lung itself. Primary lung cancer is divided into small cell lung cancer and non-small cell lung cancer, depending on how the cells look under the microscope. Secondary lung cancer is cancer that starts somewhere else in the body (for example, the breast or urinary bladder) and metastasizes (spreads) to the lungs. Identifying the type of lung cancer is important because treatment varies by type. For example, small cell cancers generally are treated with surgery. On the other hand, surgery is not generally considered beneficial for non-small cell cancers; they are treated with chemotherapy.
Small cell cancer was formerly called oat cell cancer, because the cells resemble oats in their shape. About a fourth of all lung cancers are small cell cancers. This is a very aggressive cancer and spreads to other organs within a short time. It is generally diagnosed in people who are heavy smokers. Non-small cell cancers account for the remaining 75% of primary lung cancers. They can be further subdivided into three categories.
Nearly 30% of non-small cell cancers are squamous cell carcinomas. Squamous cell carcinoma is most often found near the bronchi of patients with a history of smoking. Forty percent of non-small cell cancers are adenocarcinomas, most often found in the outer region of the lung. The remaining 10% are large-cell undifferentiated carcinomas. These rapidly spreading carcinomas may be found throughout the lung.
Incidence of lung cancer
Lung cancer is rare among young adults. It is usually found in people who are 50 years of age or older, the average age at diagnosis is 60. While the incidence of the disease is decreasing among white men, it is steadily rising among African-American men, and among both white and African-American women. This change is probably due to the increase in the number of smokers in these groups. In 1987, lung cancer replaced breast cancer as the number one cancer killer among women. Lung cancer is responsible for more deaths than the combined totals for cancers of the colon, breast, and prostate.
Causes and symptoms
SMOKING. Tobacco smoking is the leading cause of lung cancer. Ninety percent of lung cancers can be prevented by giving up tobacco. Smoking marijuana cigarettes is considered yet another risk factor for cancer of the lung. These cigarettes have a higher tar content than tobacco cigarettes. In addition, they are inhaled very deeplys a result, the carcinogens in the smoke are held in the lungs for a longer time.
EXPOSURE TO ASBESTOS AND TOXIC CHEMICALS.
Exposure to asbestos fibers, either at home or in the workplace, is also considered a risk factor for lung cancer. Studies show that compared to the general population, asbestos workers are seven times more likely to die from lung cancer. Asbestos workers who smoke increase their risk of getting lung cancer by 50-100 times. Besides asbestos, mining industry workers exposed to coal products or radioactive substances such as uranium, and workers exposed to chemicals such as arsenic, vinyl chloride, mustard gas, and other carcinogens also have a higher than average risk of contracting lung cancer.
ENVIRONMENTAL CONTAMINATION. High levels of radon, a radioactive gas that cannot be seen or smelled, pose a risk for lung cancer. This gas is produced by the breakdown of uranium, and does not present any problem outdoors. In the basements of some houses that are built over soil containing natural uranium deposits, however, radon may accumulate to dangerous levels. Other forms of environmental pollution (e.g., auto exhaust fumes) may also slightly increase the risk of lung cancer.
CHRONIC LUNG INFLAMMATION AND SCARRING. Inflammation and scar tissue are sometimes produced in the lung by diseases such as silicosis and berylliosis, which are caused by inhalation of certain minerals; tuberculosis; and certain types of pneumonia. This scarring may increase the risk of developing lung cancer.
FAMILY HISTORY. Although the exact cause of lung cancer is not known, people with a family history of lung cancer appear to have a slightly higher risk of contracting the disease.
Because lung cancers tend to spread very early, only 15% are detected in their early stages. The chances of early detection, however, can be improved by seeking medical care at once if any of the following symptoms appear:
- a cough that does not go away
- chest painshortness of breath
- persistent hoarseness
- swelling of the neck and face
- significant weight loss that is not due to dieting or vigorous exercise; fatigue and loss of appetite
- bloody or brown-colored phlegm (sputum)
- unexplained fever
- recurrent lung infections, such as bronchitis or pneumonia
Diseases other than lung cancer may cause these symptoms. It is vital, however, for patients to consult a physician to rule out the possibility that they are the presenting symptoms of lung cancer.
If the lung cancer has spread to other organs, the patient may have other symptoms such as headaches, bone fractures, pain, bleeding, or blood clots. Early detection and treatment can increase the chances of a cure for some patients; for others, it can at least prolong life.
Physical examination and initial tests
If lung cancer is suspected, the physician will take a detailed medical history to document the symptoms and assess the risk factors. The history is followed by a complete physical examination. The physician will examine the patient's throat to rule out other possible causes of hoarseness or coughing, and listen to the patient's breathing and the sounds made when the patient's chest and upper back are percussed (tapped). The physical examination, however, is not conclusive.
If there is reason to suspect lung canceruch as a history of heavy smoking or occupational exposure to substances known to irritate the lungshe physician may order a chest x ray to see if there are any masses in the lungs. Special imaging techniques, such as PET scans (positron emission tomography), CT (computerized axial tomography) scans or MRI (magnetic resonance imaging) may provide more precise information about the size, shape, and location of any tumors. X ray and other imaging techniques may be performed by a radiologic technician.
Sputum analysis involves microscopic examination of the cells that are either coughed up from the lungs, or are collected through a bronchoscope. Sputum analyses can diagnose at least 30% of lung cancers, some of which do not show up even on chest x rays. In addition, this laboratory test can help detect cancer in its very early stages, before it metastasizes (spreads) to other regions. The sputum test does not, however, provide any information about the location of the tumor and must be followed by other diagnostic tests.
Lung biopsy is the definitive diagnostic tool for cancer. It can be performed in several different ways. The physician can perform a bronchoscopy, which involves the insertion of a slender, lighted tube, called a bronchoscope, down the patient's throat and into the lungs. In addition to viewing the passageways of the lungs, the physician can use the bronchoscope to obtain samples of the lung tissue. In another procedure known as a needle biopsy, the location of the tumor is first identified using a CT scan or MRI. The physician then inserts a needle through the chest wall and collects a sample of tissue from the tumor. In the third procedure, known as surgical biopsy, the chest wall is opened up and a part of the tumor, or all of it, is removed. A pathologist, a physician who specializes in the study of diseased tissue, examines the tumor samples to identify the cancer type and stage.
Patients who will undergo surgical diagnostic and treatment procedures should be encouraged to stop smoking. Patients able to stop smoking several weeks before surgical procedures have fewer postoperative complications.
Treatment for lung cancer depends on the type of cancer, its location, and its stage. Staging is a process that describes if the cancer has metastasized and the extent of its spread. Lung cancer is staged at the time of diagnosis; this is called clinical staging. It usually is staged again following surgical intervention; this is called pathologic staging. When determining a course of treatment, the patient's age, medical history, and general state of health are taken into account. The most commonly used modes of treatment are surgery, radiation therapy, and chemotherapy.
Surgery is not usually an option for small cell lung cancers, because they have usually spread beyond the lung by the time they are diagnosed. Because non-small cell lung cancers are less aggressive, however, surgery can be used to treat them. The surgeon determines the type of surgery, depending on how much of the lung is affected. Surgery may be the primary method of treatment, or radiation therapy and/or chemotherapy may be used to shrink the tumor before surgery is attempted.
Not all patients are candidates for surgery, especially the removal of an entire lung (pneumonectomy). For example, many smokers suffer from emphysema as well as lung cancer, and as a result have sharply reduced lung capacity. Spirometric testing may be performed to assess lung capacity. The forced expiratory volume in one second (FEV1) is a laboratory test that helps to determine whether patients will have adequate pulmonary function after resection.
There are three different types of surgical operations:
- Wedge resection. This procedure involves removing a small part of the lung. A wedge resection is done when the cancer is in a very small area and has not metastasized to any other chest tissues or other parts of the body.
- Lobectomy. A lobectomy is the removal of one lobe of the lung. The right lung has three lobes and the left lung has two lobes. If the cancer is limited to one part of the lung, the surgeon will perform a lobectomy.
- Pneumonectomy. A pneumonectomy is the removal of an entire lung. If the cancer cells have spread throughout the lung, and if the surgeon feels that removal of the entire lung is the best option for curing the cancer, a pneumonectomy will be performed.
Postoperative surgical nursing care includes monitoring temperature, pulse blood pressure and respiration. Fever may indicate infection; patients are vulnerable to bacterial and viral infections. Decreased breath sounds may be symptoms of pneumothorax. The pain that follows surgery can be relieved by medications. The tendency of surgical stress to weaken the patient's immune system is treatable with antibiotics, anti-viral medicines, and vaccines.
Postoperative patient teaching encourages ambulation (walking), and reinforces patient and family understanding of surgical results and necessary follow-up.
Radiotherapy involves the use of high-energy rays to kill cancer cells. It is used either by itself or in combination with surgery or chemotherapy. Radiotherapy can be used to treat all types of cancer. The amount of radiation used depends on the size and the location of the tumor. There are two types of radiotherapy treatments, external beam radiation therapy and internal (or interstitial) radiotherapy. In external radiation therapy, the radiation
is delivered from a machine positioned outside the body. Internal radiotherapy uses a small pellet of radioactive materials placed inside the body in the area of the cancer.
Radiation therapy may produce such side effects as tiredness, skin rashes, upset stomach, and diarrhea. Dry or sore throats, difficulty in swallowing, and loss of hair in the treated area are all minor side effects of radiation. Some side effects diminish or disappear either during the course of the treatment or after the treatment is over.
Patient education by nurses and radiologic technicians includes measures to identify and manage side effects such as fatigue or radiodermatitis (skin condition resulting from radiotherapy).
Chemotherapy uses anti-cancer medications that are either given intravenously or taken by mouth. These drugs enter the bloodstream and travel throughout the body, killing cancer cells that have spread to different organs. Chemotherapy is used as the primary treatment for cancers that have spread beyond the lung and cannot be removed by surgery. It may also be used in addition to surgery or radiation therapy.
Chemotherapy is tailored to each patient's needs. The prescribed regimen depends on the type of cancer, the extent of its spread, and the patient's general state of health. Most patients are given a combination of several different drugs. Besides killing the cancer cells, these drugs also harm normal cells. Hence, the dose has to be carefully adjusted to minimize damage to normal cells. Chemotherapy often has severe side effects, including nausea, vomiting, hair loss, anemia, weakening of the immune system, and sometimes infertility. Most of these side effects end when the treatment is over. Other medications can be given to lessen the unpleasant side effects of chemotherapy.
Patient teaching helps patients and families to distinguish between anticipated side effects such as alopecia (hair loss), nausea, and constipation and the more serious side effects that require medical attention. Examples of
side effects that can not be managed at home include bleeding, fever, and confusion or hallucinations.
If the lung cancer is detected before it has had a chance to spread to other organs, and if it is treated appropriately, at least 49% of patients can survive five years or longer after the initial diagnosis. Only 15% of lung cancers, however, are found at this early stage.
Improvements in surgical technique and the development of new approaches to treatment have markedly improved the one-year survival rate for lung cancer. Slightly more than 40% of patients survive for at least a year after diagnosis, as opposed to 30% 25 years ago. The five-year survival rate for all stages of lung cancer is 14%.
Health care team roles
Lung cancer treatment involves an multidisciplinary team of health care professionals. In addition to primary care physicians, such as a family practitioner or an internist, the treatment team may include a pulmonologist, pathologist, radiologist, and thoracic surgeon as well as specialized nurses, radiologic and laboratory technicians, respiratory therapists, and dieticians.
Before, during and after treatment, nurses and allied health professionals should inform and educate patients and families about the risks and complications of any planned diagnostic test, intervention, or treatment. Patients and families should be taught about some of the common side effects of treatment, including weight loss, malnutrition, increased risk of infection, pain, fatigue, and depression.
The best way to prevent lung cancer is never to smoke or to quit smoking if one has already started. Secondhand smoke from tobacco should be avoided. Appropriate precautions should be taken when working with carcinogens (cancer-causing substances). Promoting healthy lifestyles, testing houses for the presence of radon gas, and asbestos abatement are also useful preventive strategies.
objectives of education are to prevent patients, especially children and adolescents, from smoking, and to encourage smokers to quit. Participation in smoking cessation programs should be encouraged and patients should be informed about the health risks of passive (secondhand) smoking. Patient education also should describe the role of environmental carcinogens such as asbestos and radon in the development of lung.
Biopsyhe surgical removal and microscopic examination of living tissue for diagnostic purposes.
Bronchoscope thin, flexible, lighted tube that is used to view the air passages in the lungs.
Carcinogenny substance capable of causing cancer.
Chemotherapyreatment of cancer with synthetic drugs that destroy the tumor either by inhibiting the growth of cancerous cells or by killing them.
Lobectomyurgical removal of an entire lobe of the lung.
Metastasizehe spread of cancer cells from a primary site to distant parts of the body.
Pathologist physician who specializes in the diagnosis of disease by studying cells and tissues under a microscope.
Pneumonectomyurgical removal of an entire lung.
Pneumothoraxollapse of the lung.
Radiation therapyreatment using high energy radiation from X-ray machines, cobalt, radium, or other sources.
Sputumucus or phlegm that is coughed up from the passageways of the lungs.
Stage term used to describe the size and extent of spread of cancer.
Wedge resectionemoval of only a small portion of a cancerous lung.
Groenwald, S.L. et al. Cancer Nursing Principles and Practice. Sudbury, MA: Jones and Bartlett Publishers, 1997, pp.1260-1287.
Murphy, Gerald P., et al. American Cancer Society Textbook of Clinical Oncology, Second Edition. Atlanta, GA: The American Cancer Society, Inc., 1995, pp.220-234.
Otto, S.E. Oncology Nursing. St. Louis, MO: Mosby, 1997, pp. 312-343.
"Pulmonary Disorders: Tumors of the Lung." In The Merck Manual of Diagnosis and Therapy, edited by Robert Berkow, et al. Rahway, NJ: Merck Research Laboratories, 1992.
American Cancer Society. 1599 Clifton Road, N.E., Atlanta, GA 30329. (800)227-2345.
American Lung Association. 1740 Broadway, New York, NY 10019-4374. (800)586-4872.
Cancer Research Institute. 681 Fifth Avenue, New York, NY 10022. (800)992-2623.
National Cancer Institute (National Institutes of Health). 9000 Rockville Pike, Bethesda, MD 20892. (800)422-6237.
Lung Cancer (Encyclopedia of Public Health)
Lung cancer is a malignant disease in which lung cells become abnormal, characterized by uncontrollable, unlimited growth. These cells can then invade nearby normal tissue and destroy organ structure, a process called "invasion." Lung cancer cells can also break down lung tissue structure and enter the bloodstream or lymphatic system and thus spreads to distant organs in other parts of the body, a process called metastasis. Clinically, lung cancer can be classified into two groups according to its cell types under microscopy: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer includes cancers of three cell types: squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Small cell lung cancer, also called oat cell cancer, is a less common cancer that grows faster, and is more likely to spread to other parts of the body than non-small cell lung cancer.
Lung cancer is a highly lethal disease in the United States and worldwide. According to Parkin et al. (1999), lung cancer was the most frequent cancer in 1990, worldwide, with 1.04 million new cases (771,800 in men and 265,100 in women). It is the most common cancer in men and the fifth most frequent cancer in women. Lung cancer is the leading cause of cancer deaths worldwide, with a total of 921,000 deaths per year (692,600 in men and 228,400 in women) in 1990. In the United States, it was estimated that 169,500 new lung cancer patients (90,700 men and 78,800 women) would be diagnosed and 157,400 (90,100 men and 67,300 women) would die of lung cancer in 2001. The five-year survival rate of lung cancer is 13.7 percent in the United States, 7.8 percent in developing countries, 7 percent in Eastern Europe, 7.9 percent in China, and 6.7 percent in India.
The changes (increase or decrease) of lung cancer incidence corresponds to the alterations of prevalence of smoking in the population twenty to thirty years earlier, representing a latent period between tobacco exposure and the occurrence of lung cancer. A significant decrease in the incidence of lung and bronchus cancer in males in North America started in the late 1980s. Between 1990 and 1996 there was a 2.6 percent decline in incidence per year. Incidence rates of lung and bronchus cancer in females are stabilizing in the United States. Although the death rate from lung cancer in males is decreasing, it is increasing among females, and it has now exceeded the breast cancer death rate among females.
Tobacco smoking is a major cause of lung cancer. Over 4,000 chemical compounds have been identified in the tobacco leaf. Carcinogens in tobacco smoke can damage the cells in the lungs, which may lead to the development of lung cancer. More than fifty chemical compounds in tobacco smoke have been recognized as known or probable human carcinogens, some of which may be formed during combustion (or smoking) and some which may exist naturally in tobacco. Several groups of carcinogens in tobacco smoke are related to lung cancer, including polycyclic aromatic hydrocarbons (PAHs), aromatic amines, benzene, hydrazine, and vinyl chloride. Smoking results in damage to the bronchial and lung epithelium, which leads to lung cell proliferation and finally to lung cancer. Animal studies confirm the carcinogenic potential of tobacco smoke in tissues having smoke contact: in these studies smoke exposure leads to laryngeal tumors and pulmonary adenomas. In humans, cigarette smokers have increased levels of tobacco carcinogen DNA adducts in the lung and bronchus when compared with nonsmokers.
A very strong association between cigarette smoking and lung cancer has been consistently observed in studies done since the early 1950s. These studies have shown that cigarette smoking precedes lung cancer occurrence. It has been estimated that cigarette smokers have a ten-fold higher risk of lung cancer, in comparison with nonsmokers. With the increased number of cigarettes smoked per day, the risk is increasedeavy smokers are at greater risk of lung cancer than moderate smokers; and moderate smokers are at higher risk than light smokers and nonsmokers. The risk for individuals who smoke two or more packs per day is about twenty times that of nonsmokers, and longer smoking duration has a stronger effect on the risk of lung cancer. Beginning to smoke at an early age is also related to an increased risk, and the lung cancer risk declines with an increased duration of cessation. The percentage of reduction in risk after quitting smoking depends on the duration of exposure to smoking. The observed relationship between cigarette smoking and the risk of lung cancer is consistent with different study designs and in studies of different populations all over the world. Over eighty-five percent of deaths from lung cancer can be attributed to cigarette smoking. It is estimated that tobacco smoking accounts for over ninety percent of male lung cancer deaths and seventy-nine percent of female lung cancer deaths in the United States.
Smoking of other tobacco products, such as cigar and pipe smoking, is also associated with an increased risk of lung cancer. Like cigarette smoking, the risk of lung cancer is increased with the frequency and years of cigar and pipe smoking. Environmental tobacco smoke (ETS), also known as secondhand smoke, increases the risk of lung cancer among nonsmokers. It is estimated that ETS may lead to 3,000 new cases of lung cancer per year in nonsmokers in the United States. Other risk factors for lung cancer include race, occupational exposures (e.g., arsenic, asbestos, chromium, mustard gas, PAHs), residential radon exposure, radiation, air pollution, and nutritional factors. The host susceptibility factors for lung cancer include inheritance of different polymorphic genotypes that may interact with tobacco smoke in determining the risk of lung cancer.
Smoking cessation or lifelong abstinence from smoking offer the best opportunities to reduce lung cancer incidence and death rates. Reducing the prevalence of smoking will lead to a dramatic decrease in the incidence of lung cancer in the general population. According to the Centers for Disease Control and Prevention (CDC), cigarette smoking is the single most preventable cause of premature death in the United States. More than 400,000 people die from causes attributable to cigarette smoking each year, including 276,000 men and 142,000 women. The promotion of smoking cessation is the most cost-effective tool against lung and other smoking-related cancers and diseases.
Control of other risk factors, such as workplace exposures associated with the increased risk of lung cancer, environmental tobacco smoke, and radon exposure in residences, may also lead to a reduced risk of lung cancer. Sputum cytology and chest radiographs are not recommended for lung cancer screening because no favorable impact of the screening on lung cancer mortality has been demonstrated. Recent developments have pointed out that the molecular genetic alterations associated with progression toward lung cancer, such as p53 mutations in sputum samples, may help to identify high-risk individuals for early detection and chemoprevention.
(SEE ALSO: Cancer; Causes of Death; Chronic Illness; Environmental Tobacco Smoke; Noncommunicable Disease Control; Smoking Behavior; Smoking Cessation; Women's Health)
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Parkin, D. M.; Pisani, P.; and Ferlay, J. (1999). "Estimates of the Worldwide Incidence of 25 Major Cancers in 1990." International Journal of Cancer 80: 82741.
Pisani, P.; Parkin, D. M.; Bray F.; and Ferlay, J. (1999). "Estimates of the Worldwide Mortality from 25 Cancers in 1990." International Journal of Cancer 83:189.
Samet, J. M. (1995). "Lung Cancer." In Cancer Prevention and Control, eds. P. Greenwald, B. S. Kramer, and D. L. Weed. New York: Marcel Dekker.