Epidemiology

Examine the Prevalence of lung cancer among veterans and the general population, the high mortality risk, histological differences between small cell and non-small cell lung cancer, and common causes of the disease.

MORTALITY

In 2015, Lung cancera was predicted to cause as many deaths as colon,b pancreatic, prostate, and breast cancer combined1

  • Approximately 221,200 new cases of lung cancer and 160,000 deaths were estimated in 2015
  • Death from lung cancer is the most common cancer death in men and women

aIncludes lung and bronchus.
bIncludes colon and rectum.

Reference: 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin.2015;65(1);5-29.

PREVALENCE

New Cases of  Lung and Bronchus Cancer Among Veterans and the General Population Diagnosed in 20131,2

Examining data from the National Cancer Institute and the Veterans Health Administration provides insight into the prevalence of lung cancer in these populations

  • Approximately 6.6% of men and women will be diagnosed with lung cancer at some point during their lifetime3
  • An estimated 66% of people diagnosed with lung cancer are aged  ≥ 65 years, and <2% of cases are diagnosed in people aged <45 years4
  • The median age of lung cancer diagnosis is 70 years3
  • In the general US populations, 56% of patients with lung and bronchus cancer have advanced disease at diagnosis2

References: 1. VHA Support Service Center (VSSC). Top 25 malignant neoplasm diagnosis by ICD-9 code: veterans diagnosed in FY 2013. Data accessed from VSSC Diagnosis Cube, March 26, 2014. 2. Siegel R, Naishadham D, jemal A, Cancer statistics, 2013 CA Cancer  J Clin. 2013;63(1):1 1.30 . 3. National Cancer institute. SEER stat fact sheets: lung and bronchus cancer. http://seer.cancer.gov/statfacts/html/lungb.html. Accessed March 31, 2015. 4. American Cancer Society. Lung cancer (non-small cell). http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.pdf. Last medical review August 15, 2014. Last revised March 11, 2016 Accessed March 14, 2016.

HISTOLOGY

Small cell and non-small cell lung cancer

* images Courtesy of Dr  Ignacio Wistuba, MD, at MD Anderson Cancer Center

References: 1. American Cancer Society. Cancer fact & figures 2015. http://www.cancer.org/acs/groups/content/@editorial/docu-
ments/document/acspc-044522.pdf Accessed March 20, 2015. 2. National cancer Institute. Small cell lung cancer treatment-for health professionals (PDQ®). http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq. Update February 18, 2016. Accessed March 14, 2016. 3. Govindan R, Page N, Morgenszetrn D,et al Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveilleance, epidemiologic, and end result database J Clin Oncol. 2006;24(28);4539-4544. 4. Elias AD. Small cell lung cancer: state-of-the-art-therapy in 1996. Chest. 1997; 112(4);2515-2585.  5. Perez-Moreno P, Brambilla E, Thomas R, Sorial J-C. Squamous cell carcinoma of the lung; molecular subtypes and therapeutic opportunities. Clin Cancer Res. 2012;18(9)2443-2451. 6. National Cancer Institute. Non-small call lung cancer treatment-health professional version (PDQ®). https://www.cancer.gov/types/lung/hp/non-small-cell-treatment-psq#selction/all. Update January 22, 2016 Accessed  March 14, 2016.  7. National Cancer Institute. SEER stat fact sheets: lung and bronchus cancer. http://seer.cancer.gov/statfacts/html/lungb.html.

CAUSES

Smoking is responsible for 80% to 90% of lung cancer in men and women1

  • The prevalence of smoking is higher among veterans than the general population2
     -A survey* including 224,169 US veterans found that 27% of veterans smoked vs 21% of the general population
  • NSCLC patients who smoke have a lower overall survival vs patient who never smoked3
  • Male Smokers are about 25 time more likely and female smokers are about 26 time more likely than their nonsmoking counterparts to develop lung cancer4
  • Each year, an estimated 7,000 adults die of lung cancer as a result of secondhand smoke4

 

Other Causes:

  • Environmental risk factors
    -Radon gas is the leading cause of lung cancer in nonsmoker4
    -Chemical such as asbestos, arsenic, and diesel exhaust can increase risk of lung cancer4,5
    -Indoor and outdoor air pollution can increase the risk of lung cancer in nonsmoker4,6
  • Family history
    -Individuals with a relative who has had lung cancer may be twice as likely to have lung cancer5
  • Pre-existing conditions
    -History of other cancers5
    -History of lung disease

*Based on data from the 2003-2007 Behavioral Risk factor Surveillance System (BRFSS), a state-based survey supported by the CRC .

References : 1. National cancer Institute. Lung cancer prevention (PDQ®). http://www.cancer.gov/cancertopics/pdq/prevention/lung/Pa-tient/page3#Keypoint5. Last modified December 3, 2013. Accessed June 24, 2014.  2. Brown DW. Smoking prevalence among US veterans. J Gen Intern Med. 2009;25(2):147-149.  3. Kawaguchi T, Takada M, Kubo A, et al. Performance status and smoking status are independent favorable prognostic factors for survival  in non-small cell lung cancer: a comprehensive analysis of 26,597 patients with NSCLC . J Thorac Oncol. 2010;(5):620-630.  4. Simon S. Why non smokers sometimes get lung cancer. American Cancer Society. http://www.cancer.org/cancer/news/why-lung-cancer-strikes-non-smokers. Published October 30, 2015. Accessed March 8, 2016. 5.  American Cancer Society. Lung cancer (non-small cell). http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.pdf. Last medical review August 15, 2014. Last revised March 11, 2016. Accessed March 14, 2016. 6. Turner MC, Krewski D, Pope CA, Chen Y, Gapstur SM. Thun MJ. Long-term ambient fine particulate matter air pollution and lung cancer in a large cohort of never-smokers, Am J Respir Crit Care Med. 2011;184:1374-1381.

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