Non-Small Cell Lung Cancer: Epidemiology, Risk Factors, Treatment, and Survivorship

Abstract

Lung cancer is the leading cause of cancer-related mortality not only in the United States but also around the world. In North America, lung cancer has become more predominant among former than current smokers. Yet in some countries, such as China, which has experienced a dramatic increase in the cigarette smoking rate during the past 2 decades, a peak in lung cancer incidence is still expected. Approximately two-thirds of adult Chinese men are smokers, representing one-third of all smokers worldwide. Non-small cell lung cancer accounts for 85% of all lung cancer cases in the United States. After the initial diagnosis, accurate staging of non-small cell lung cancer using computed tomography or positron emission tomography is crucial for determining appropriate therapy. When feasible, surgical resection remains the single most consistent and successful option for cure. However, close to 70% of patients with lung cancer present with locally advanced or metastatic disease at the time of diagnosis. Chemotherapy is beneficial for patients with metastatic disease, and the administration of concurrent chemotherapy and radiation is indicated for stage III lung cancer. The introduction of angiogenesis, epidermal growth factor receptor inhibitors, and other new anti-cancer agents is changing the present and future of this disease and will certainly increase the number of lung cancer survivors. We identified studies for this review by searching the MEDLINE and PubMed databases for English-language articles published from January 1, 1980, through January 31, 2008. Key terms used for this search included non-small cell lung cancer, adenocarcinoma, squamous cell carcinoma, bronchioalveolar cell carcinoma, large cell carcinoma, lung cancer epidemiology, genetics, survivorship, surgery, radiation therapy, chemotherapy, targeted therapy, bevacizumab, erlotinib, and epidermal growth factor receptor.

Contribution of upregulated dipeptidyl peptidase 9 (DPP9) in promoting tumoregenicity, metastasis and the prediction of poor prognosis in non‐small cell lung cancer (NSCLC)

“…Survival outcome varies among NSCLC patients, even within groups that present with the same stage at the time of diagnosis and who were treated in similar strategies 5, 47. Therefore, there is a need to develop accurate individual prognostic factors.…”

“…The two main types of lung cancer are small‐cell lung cancer and non‐small‐cell lung cancer (NSCLC), with the latter accounting for approximately 85% of total Lung cancer diagnoses 2, 3. In recent years, despite the great progress that has been made in diagnosis and combined treatments including surgical resection, chemotherapy, radiation therapy, and targeted biological agents,4 the overall prognosis of NSCLC patients remains poor, with a 5‐year survival rate of approximately 15% 5. Therefore, more intensive efforts should be made to investigate the initiation and progression of NSCLC.…”

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

“…Lung cancer is second most common cancer, and 85% of them are non‐small cell lung carcinoma (NSCLC) 8. Although several researchers have observed a high risk of suicide among lung cancer patients (being discussed as a single cancer entity), further examinations of patients with the most common subtype of lung cancer (NSCLC) are required, because of totally different distribution, treatment strategy and prognosis between subtypes 2, 7, 9.…”

Efficacy and safety of maintenance pemetrexed in patients with advanced nonsquamous non-small cell lung cancer following pemetrexed plus cisplatin induction treatment: A cross-trial comparison of two phase III trials

“…Approximately 85% of lung cancers are nonsmall cell (NSCLC), and more than 70% of patients with NSCLC present with inoperable, locally advanced (Stage IIIB) or metastatic (Stage IV) disease [1].…”