Lung and pleural cancers

Lung cancer is the most frequently diagnosed cancer in the world, and the prevalence of lung cancer is increasing globally (Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000;38:453-70). It is the leading cause of death from cancer, and the death occurs at a higher frequency in men than in women in most parts of the world (Magrath I, Litvak J. Cancer in developing countries: opportunity and challenge. J Natl Cancer Inst 1993;85:862-73). There were 169,400 estimated new cases of lung cancer in 2002. Lung cancer claims approximately 150,900 lives each year in the United States, and 20,000 more women died of lung cancer than breast cancer in 2002 (Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin 2002;52:23-47). The survival rate is poor, largely because lung cancer is usually diagnosed at an advanced stage. The overall 5-year survival of patients with lung cancer is approximately 14% and has remained unchanged over several decades despite aggressive treatment protocols (Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin 2002;52:23-47). Therefore, new diagnostic and treatment strategies are needed if an impact is to be made on the survival of patients with lung cancer. A cure may be achieved by surgery, which is feasible only in patients who present at an early stage. However, even in the early stage, approximately 75% of patients will die of recurrent disease (Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000;38:453-70, Bepler G. Lung cancer epidemiology and genetics. J Thorac Imaging 1999;14:228-34). Lung cancer is rare before the age of 40 years, after which age-specific rates rise sharply. The ages with the greatest incidence are between 65 and 79 years (Smith RA, Glynn TJ. Epidemiology of lung cancer. Radiol Clin North Am 2000;38:453-70).