The Pharmaceutical Journal
Vol 277 No 7424 p521-524
28 October 2006

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An overview of lung cancer

November is Lung Cancer Awareness Month. With public smoking bans springing up over Europe and investment in campaigns to discourage the habit in the UK, perhaps more of the future generation will see smoking as unattractive. But what about those for whom such interventions have come too late? In this article, Michael Peake explains why it is important to be alert to lung cancer

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SUMMARY

Lung cancer is a term that covers a variety of malignant tumours within the lungs and the surrounding pleural membrane, although it excludes the asbestos-related pleural tumour, malignant mesothelioma. It is one of the most common forms of cancer and the commonest cause of cancer-related death, with an estimated 1.18 million people dying worldwide from the disease in 2002. In the same year, there were 33,600 deaths from lung cancer in the UK, making up 22 per cent of all cancer deaths. This compares with 12,900 deaths from breast cancer, 16,200 from colorectal cancer and 9,900 from prostate cancer— lung cancer now exceeds breast cancer as the most common cause of death from cancer in women in many parts of the world, including the UK. These facts are not well publicised and a long-standing lack of media interest in lung cancer has resulted in a low level of public awareness.

The incidence of lung cancer and death from it in males increased steadily between the 1950s and the end of the ’80s but since then it has steadily fallen — the decline has not yet plateaued. In women, the incidence has always been below that in men, but this has steadily increased since the 1970s. The male to female ratio has shifted from almost 6:1 in the early 1970s to around 2:1 in the early 2000s. These trends parallel the trends in the prevalence of smoking in both sexes over the period, though with a 20–25 year lag time.

The mean age at diagnosis is around 70 years but this means, of course, that half of the cases occur in individuals younger than 70 years old and patients with lung cancer in their 40s and 50s are common in clinical practice.

Across the UK there is wide variation in the incidence of lung cancer and there is a strong correlation between socio-economic status and its frequency in the population, the highest incidences being in the lowest socio-economic groups. The fact that lung cancer is most common in older, male, working class smokers probably explains why it is of less interest to the media than breast cancer.

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