Travis W D, Travis L B, Devesa S S
Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Cancer. 1995 Jan 1;75(1 Suppl):191-202. doi: 10.1002/1097-0142(19950101)75:1+<191::aid-cncr2820751307>3.0.co;2-y.
Lung cancer is the most common cause of cancer death in the United States, and its incidence has been rising for at least 50 years. Shifts in histologic type and differences in sex and race distribution have accompanied the increased incidence of lung malignancies.
Population-based data regarding lung cancer reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program for the 15-year period 1973-1987 were analyzed.
Results indicate that from 1973-1977 to 1983-1987, the age-adjusted rates of lung cancer increased by 30%, with the gain markedly greater in women (70%) than in men (17%). The largest percentage increases in age-adjusted rates were observed for small cell carcinoma and adenocarcinoma (approximately 60% each), with a more modest change for squamous cell carcinoma (+ 14%). For squamous cell carcinoma, the age-adjusted rates increased substantially for black (65%) and white (70%) women and only slightly for black men (10%), whereas it decreased slightly in recent years for white men.
In recent years, adenocarcinoma has replaced squamous cell carcinoma as the most frequent histologic subtype for all sexes and races combined. These shifts in histologic types by sex and race may be related to differences in exposure to tobacco products, dietary factors, environmental or occupational carcinogens, and host characteristics. Increased use of transbronchial and needle biopsy may have also influenced these trends to some extent. Over the study period, 5-year relative survival rate did not change appreciably for lung cancer, suggesting that therapeutic advances have had little effect.
肺癌是美国癌症死亡的最常见原因，其发病率至少在50年里一直在上升。肺癌发病率的增加伴随着组织学类型的变化以及性别和种族分布的差异。
分析了1973年至1987年这15年间向美国国家癌症研究所的监测、流行病学和最终结果（SEER）计划报告的基于人群的肺癌数据。
结果表明，从1973 - 1977年到1983 - 1987年，年龄调整后的肺癌发病率增加了30%，女性的增幅（70%）明显大于男性（17%）。年龄调整率增幅最大的是小细胞癌和腺癌（各约60%），鳞状细胞癌的变化较小（+14%）。对于鳞状细胞癌，黑人（65%）和白人（70%）女性的年龄调整率大幅上升，黑人男性仅略有上升（10%），而近年来白人男性的该比率略有下降。
近年来，腺癌已取代鳞状细胞癌，成为所有性别和种族综合起来最常见的组织学亚型。按性别和种族划分的这些组织学类型变化可能与接触烟草制品、饮食因素、环境或职业致癌物以及宿主特征的差异有关。经支气管和针吸活检的使用增加在一定程度上也可能影响了这些趋势。在研究期间，肺癌的5年相对生存率没有明显变化，这表明治疗进展的效果甚微。
