Stone Emily, Vachani Anil
Department of Thoracic Medicine, St Vincent's Hospital and Kinghorn Cancer Centre, Sydney, Australia.
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Semin Respir Crit Care Med. 2016 Oct;37(5):649-658. doi: 10.1055/s-0036-1592115. Epub 2016 Oct 12.
The lung cancer epidemic of the twentieth century grew out of increasing tobacco consumption in the first half of that century. Tobacco control policies have been instituted in many high-income countries since the mid-1960s. Since then smoking rates have declined in these countries, particularly in men where lung cancer rates have stabilized. Tobacco control measures are not strong enough in many countries around the world, particularly low and middle income countries in Eastern Europe and Asia. In these countries, smoking rates and lung cancer rates remain high. Tobacco cessation is more successful in countries with stronger tobacco control and confers quality of life and survival benefits in smokers including lung cancer patients. A significant degree of stigma surrounds the diagnosis of lung cancer which is often considered "self-inflicted" even though the tobacco industry promotes smoking uptake and maintenance. Sustained, effective tobacco control and cessation may improve lung cancer outcomes and are key considerations in modern care of lung cancer patients.
20世纪的肺癌流行源于该世纪上半叶烟草消费的不断增加。自20世纪60年代中期以来,许多高收入国家已制定烟草控制政策。从那时起,这些国家的吸烟率有所下降,尤其是男性,其肺癌发病率已趋于稳定。世界上许多国家,特别是东欧和亚洲的中低收入国家,烟草控制措施不够有力。在这些国家,吸烟率和肺癌发病率仍然很高。在烟草控制更强的国家,戒烟更成功,并且能为吸烟者(包括肺癌患者)带来生活质量和生存益处。肺癌诊断存在很大程度的污名化,即使烟草行业促进吸烟并维持吸烟行为,但肺癌往往被认为是“自我造成的”。持续、有效的烟草控制和戒烟可能改善肺癌治疗结果,并且是现代肺癌患者护理中的关键考虑因素。