Thandra Krishna Chaitanya, Barsouk Adam, Saginala Kalyan, Aluru John Sukumar, Barsouk Alexander
Department of Pulmonary and Critical Care Medicine, Sentara Virginia Beach General Hospital, Virginia Beach, VA, USA.
Hillman Cancer Center, University of Pittsburgh, PA, USA.
Contemp Oncol (Pozn). 2021;25(1):45-52. doi: 10.5114/wo.2021.103829. Epub 2021 Feb 23.
Lung cancer is the leading cause of global cancer incidence and mortality, accounting for an estimated 2 million diagnoses and 1.8 million deaths. Neoplasms of the lungs are the second most common cancer diagnosis in men and women (after prostate and breast cancer, respectively). With increasing access to tobacco and industrialization in developing nations, lung cancer incidence is rising globally. The average age of diagnosis is 70 years old. Men are twice as likely to be diagnosed with lung cancer, which largely reflects differences in tobacco consumption, although women may be more susceptible due to higher proportions of epidermal growth factor receptor mutations and the effects of oestrogen. African American men in the US are at the highest risk of lung cancer. Family history increases risk by 1.7-fold, with a greater risk among first-degree relatives. Tobacco smoking is the greatest preventable cause of death worldwide, accounting for up to 90% of lung cancer cases, and continued consumption is projected to increase global cancer incidence, particularly in developing nations such as China, Russia, and India. Second-hand smoke among children and spouses has likewise been implicated. Radon from natural underground uranium decay is the second leading cause of lung cancer in the developed world. Occupational hazards such as asbestos and environmental exposures such as air pollution, arsenic, and HIV and Tb infection have all been implicated in lung carcinogenesis, while cannabis smoking, electronic cigarettes, heated tobacco products, and COVID-19 have been hypothesized to increase risk.
肺癌是全球癌症发病率和死亡率的首要原因,估计有200万例诊断病例和180万例死亡病例。肺癌是男性和女性中第二常见的癌症诊断(分别仅次于前列腺癌和乳腺癌)。随着发展中国家烟草获取途径的增加和工业化进程的推进,全球肺癌发病率正在上升。肺癌的平均诊断年龄为70岁。男性被诊断出患有肺癌的可能性是女性的两倍,这在很大程度上反映了烟草消费的差异,尽管由于表皮生长因子受体突变比例较高以及雌激素的影响,女性可能更易患肺癌。美国非裔美国男性患肺癌的风险最高。家族史会使风险增加1.7倍,一级亲属中的风险更高。吸烟是全球最大的可预防死亡原因,占肺癌病例的比例高达90%,预计持续吸烟将增加全球癌症发病率,尤其是在中国、俄罗斯和印度等发展中国家。儿童和配偶接触二手烟同样被认为与肺癌有关。天然地下铀衰变产生的氡是发达国家肺癌的第二大主要病因。职业危害如石棉以及环境暴露如空气污染、砷、艾滋病毒和结核病感染都与肺癌发生有关,而吸食大麻、电子烟、加热烟草制品和感染新冠病毒被推测会增加患癌风险。