肺癌的流行病学:肺癌的诊断与管理,第 3 版:美国胸科学会循证临床实践指南。
Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.
机构信息
Hollings Cancer Center and the Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
Department of Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD.
出版信息
Chest. 2013 May;143(5 Suppl):e1S-e29S. doi: 10.1378/chest.12-2345.
BACKGROUND
Ever since a lung cancer epidemic emerged in the mid-1900 s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research.
METHODS
A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk.
RESULTS
Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application.
CONCLUSIONS
Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers.
背景
自 20 世纪中叶出现肺癌流行以来,人们一直在深入研究肺癌的流行病学,以明确其病因和发病模式。本报告总结了这方面研究的主要发现。
方法
详细的文献检索为叙述性综述提供了基础,确定并总结了有关人群模式和影响肺癌风险因素的主要报告。
结果
已确定的肺癌环境危险因素包括吸烟和使用其他烟草制品以及接触二手烟、职业性肺癌致癌物、辐射以及室内和室外空气污染。吸烟是肺癌的主要病因,也是全世界癌症死亡的首要原因。发展中国家的吸烟率有所上升,在这些国家引发了新的肺癌流行。阳性家族史和获得性肺部疾病是具有临床意义的风险指标的宿主因素的例子。已经开发了基于肺癌危险因素的风险预测模型,但需要进一步完善,以提供具有临床意义的风险分层。已经确定了一些有希望的肺癌风险和早期检测的生物标志物,但尚无一种可广泛用于临床。
结论
几乎所有肺癌死亡都归因于吸烟,这突显了在全世界继续开展烟草控制工作的必要性。需要进一步研究肺癌差异的原因、不吸烟者患肺癌的原因、HIV 在肺癌发生中的潜在作用以及生物标志物的开发。