Lung cancer

Lung cancer is the most common cause of cancer deaths in the world. In the U.S., approximately 170,000 cases and 155,000 deaths are predicted for 2002.1 Lung cancer accounts for 29% of all cancer deaths and causes more deaths than breast, colorectal and prostate cancer combined. While the prognosis of patients with lung cancer has improved over the past 20 years, overall it remains poor. Fewer than 15% of patients survive for more than 5 years. The poor prognosis is largely attributable to the fact that approximately 70% of lung cancer patients are diagnosed with mediastinal lymph node involvement, malignant effusion or distant metastases. In the US approximately 45 million people are current smokers and another 40-50 million are former smokers. Elimination of tobacco use as primary prevention of lung cancer should remain a priority for teenagers and young adults. However, considering the large pool of individuals at risk, lung cancer will undoubtedly remain a significant public health problem in the coming decades. Given our current inability to cure patients with metastatic disease, intensive efforts should be aimed at early identification and intervention. While screening and, more recently, chemoprevention have significantly impacted the incidence and survival of other cancers, such as breast, cervical and colorectal cancer, chemopreventive strategies for lung cancer have not shown clear benefits. In addition, radiographic screening is still controversial. In this review, we will provide a summary of the recent developments in the areas of molecular epidemiology, screening and chemoprevention with special emphasis on women.