Lung Cancer Susceptibility and Risk Assessment Models

Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Although smoking is the predominant risk factor for LC, there are also additional modifiable risk factors for LC. In addition, genetic susceptibility plays an important role in LC. Recent genome-wide associations studies (GWAS) have identify a number of LC susceptibility loci. Different race/ethnicity and histology have common and distinct susceptibility loci. Specific LC susceptibility loci in never smokers have also been found. Intermediate phenotypic biomarkers, for example, suboptimal DNA repair capacity in peripheral blood cells, have been consistently associated with an increased risk of LC. Several risk prediction models, from case-controls studies and cohort studies, for LC have been developed with modest prediction efficiency. Future efforts should be focused on identifying additional genetic factors and intermediated biomarkers through various "omics" approach and next generation sequencing, exploring gene-gene, gene-environment interaction, and ultimately integrating modifiable risk factors, biomarkers, and their interactions into a comprehensive risk assessment model. An improved risk prediction model for LC will help identify those high-risk individuals who would be candidates for cost-effective tobacco cessation, surveillance and screening.