US lung cancer trends by histologic type

Authors

  • Denise Riedel Lewis PhD, MPH,

    Corresponding author
    1. Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
    • Corresponding author: Denise Riedel Lewis, PhD, MPH, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892; Fax: (240) 276-7908; lewisde@mail.nih.gov

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  • David P. Check BS,

    1. Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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  • Neil E. Caporaso MD,

    1. Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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  • William D. Travis MD,

    1. Memorial Sloan Kettering Cancer Center, New York, New York
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  • Susan S. Devesa PhD

    1. Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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  • This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  • We thank Ms. Lois Dickie, Certified Tumor Registrar, Surveillance Research Program, National Cancer Institute, for consultation regarding lung cancer histologies.

Abstract

BACKGROUND

Lung cancer incidence rates overall are declining in the United States. This study investigated the trends by histologic type and demographic characteristics.

METHODS

Surveillance, Epidemiology, and End Results (SEER) program rates of microscopically confirmed lung cancer overall and squamous cell, small cell, adenocarcinoma, large cell, other, and unspecified carcinomas among US whites and blacks diagnosed from 1977 to 2010 and white non-Hispanics, Asian/Pacific Islanders, and white Hispanics diagnosed from 1992 to 2010 were analyzed by sex and age.

RESULTS

Squamous and small cell carcinoma rates declined since the 1990s, although less rapidly among females than males. Adenocarcinoma rates decreased among males and only through 2005, after which they then rose during 2006 to 2010 among every racial/ethnic/sex group; rates for unspecified type declined. Male/female rate ratios declined among whites and blacks more than among other groups. Recent rates among young females were higher than among males for adenocarcinoma among all racial/ethnic groups and for other specified carcinomas among whites.

CONCLUSIONS

US lung cancer trends vary by sex, histologic type, racial/ethnic group, and age, reflecting historical cigarette smoking rates, duration, cessation, cigarette composition, and exposure to other carcinogens. Substantial excesses among males have diminished and higher rates of adenocarcinoma among young females have emerged as rates among males declined more rapidly. The recognition of EGFR mutation and ALK rearrangements that occur primarily in adenocarcinomas are the primary basis for the molecular revolution that has transformed lung cancer diagnosis and treatment over the past decade, and these changes have affected recent type-specific trends. Cancer 2014;120:2883–2892. © 2014 American Cancer Society.

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