Alberg Anthony J, Nonemaker Jill
Hollings Cancer Center, Medical University of South Carolina, Charleston SC 29425, USA.
Semin Respir Crit Care Med. 2008 Jun;29(3):223-32. doi: 10.1055/s-2008-1076742.
Lung cancer is the leading cause of cancer death in the world. However, there is large geographic variation internationally and within nations. Despite the fact that many causes of lung cancer have been established, cigarette smoking is the principal cause. Accounting for historical prevalence of cigarette smoking is a useful predictor of the lung cancer burden in most populations. The populations at high present risk of lung cancer can usually be predicted based on historical patterns of the prevalence of cigarette smoking, and the high-risk populations of the future can be predicted based on the current prevalence of cigarette smoking. Lung cancer rates are consistently higher among men than women and are particularly high among African American men and among those of lower socioeconomic status. At the individual level, some segments of the population (e.g., African Americans, females) have been hypothesized to have greater susceptibility to lung cancer for a given degree of cigarette smoking. Common variants in genes that encode for enzymes involved in carcinogen metabolism and detoxification and in repairing DNA damage are likely to be important determinants of interindividual susceptibility to smoking-caused lung carcinogenesis. Many lung cancer risk factors have been identified, but active cigarette smoking is the predominant cause of lung cancer and the principal marker of both high-risk populations and high-risk individuals. In the absence of cigarette smoking, lung cancer would be a rare disease. Strategies that effectively prevent youths from starting to smoke and that promote cessation among dependent smokers can transform populations from high risk to low risk.
肺癌是全球癌症死亡的主要原因。然而，在国际和国内都存在很大的地域差异。尽管已经确定了许多肺癌病因，但吸烟是主要原因。考虑吸烟的历史流行情况是大多数人群肺癌负担的一个有用预测指标。通常可以根据吸烟流行的历史模式预测当前肺癌高风险人群，也可以根据当前吸烟流行情况预测未来的高风险人群。肺癌发病率男性始终高于女性，在非裔美国男性和社会经济地位较低者中尤其高。在个体层面，有人假设某些人群（如非裔美国人、女性）在同等吸烟程度下对肺癌更易感。编码参与致癌物代谢、解毒及修复DNA损伤的酶的基因中的常见变异，可能是个体间对吸烟所致肺癌发生易感性的重要决定因素。已确定了许多肺癌风险因素，但主动吸烟是肺癌的主要病因，也是高风险人群和高风险个体的主要标志。如果不吸烟，肺癌将是一种罕见疾病。有效防止年轻人开始吸烟并促使依赖吸烟者戒烟的策略，可以使人群从高风险转变为低风险。
