Williams M D, Sandler A B
Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Cancer Treat Res. 2001;105:31-52. doi: 10.1007/978-1-4615-1589-0_2.
Lung cancer continues to be the leader in cancer deaths in the United States. The incidence of lung cancer in men has slowly decreased since the late 1980s, but has just now begun to plateau in women at the end of this decade. Despite modest advances in chemotherapy for treating lung cancer, it remains a deadly disease with overall 5-yr survival rates having not increased significantly over the last 25 years, remaining at approximately 14%. Tobacco smoking causes approximately 85-90% of bronchogenic carcinoma. Environmental tobacco exposure or a second-hand smoke also may cause lung cancer in life-long non-smokers. Certain occupational agents such as arsenic, asbestos, chromium, nickel and vinyl chloride increase the relative risk for lung cancer. Smoking has an additive or multiplicative effect with some of these agents. Familial predisposition for lung cancer is an area with advancing research. Developments in molecular biology have led to growing interest in investigation of biological markers, which may increase predisposition to smoking-related carcinogenesis. Hopefully, in the future we will be able to screen for lung cancer by using specific biomarkers. Finally, dietary factors have also been proposed as potential risk modulators, with vitamins A, C and E proposed as having a protective effect. Despite the slow decline of smoking in the United States, lung cancer will likely continue its devastation for years to come.
肺癌仍然是美国癌症死亡的首要原因。自20世纪80年代末以来，男性肺癌的发病率一直在缓慢下降，但直到这十年末，女性肺癌发病率才刚刚开始趋于平稳。尽管在肺癌化疗方面取得了一定进展，但它仍然是一种致命疾病，在过去25年里，其总体5年生存率并未显著提高，仍约为14%。吸烟导致约85%至90%的支气管源性癌。接触环境烟草或二手烟也可能导致终生不吸烟者患肺癌。某些职业因素，如砷、石棉、铬、镍和氯乙烯，会增加患肺癌的相对风险。吸烟与其中一些因素具有相加或相乘效应。肺癌的家族易感性是一个正在深入研究的领域。分子生物学的发展使得人们对生物标志物的研究兴趣日益浓厚，这些生物标志物可能会增加与吸烟相关的致癌易感性。有望在未来，我们能够通过使用特定的生物标志物来筛查肺癌。最后，饮食因素也被认为是潜在的风险调节因素，有人提出维生素A、C和E具有保护作用。尽管美国吸烟率在缓慢下降，但肺癌在未来几年可能仍会继续造成严重破坏。
