Epidemiology of lung cancer and the gender differences in risk
1Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL 60153, USA
DOI: 10.31083/j.jomh1803073 Vol.18,Issue 3,March 2022 pp.1-10
Submitted: 30 November 2021 Accepted: 17 January 2022
Published: 31 March 2022
Background: Lung cancer has progressed from an exceedingly rare disease to the leading cause of all cancer-related deaths, a phe-nomenon largely attributed to the impact of tobacco smoking and resulting global epidemic. Methods: A thorough literature search was conducted to identify relevant factors in the epidemiology of lung cancer with a focus on recent studies and developments that had the most significant impact on the current understanding of lung cancer. Results: Most recent data suggests the global burden of lung cancer is continuing to rise with 2.2 million new cases in 2020 alone. Although no difference is noted among men, a higher rate of lung cancer deaths among women in the industrialized countries are observed compared to developing nations. Incidence and deaths are closely linked to cigarette smoking. Other risk factors include occupational hazards, increasing air pollution with pulmonary infectious diseases and inflammatory conditions, and genetic factors. Tobacco continues to cause approximately 90% of all lung cancer deaths with a markedly wide variety of incidence rates both geographically and between males and females. Lung cancer incidence has been falling in US and UK since 1990 largely due to comprehensive tobacco control programs. In contrast higher rates of cigarette smoking among emerging nations is a concern. The unprecedented, widespread adoption of electronic-cigarette use among adolescents may pose major obstacles in the prevention and treatment of lung cancer. Conclusions: While the vast majority of current lung cancer cases and deaths continue to be caused by tobacco consumption, shifts in population behaviors, geographical location, and potential new causes may alter this distribution. Further work is crucial in order to better understand the risk factors for lung cancer in the modern world so that a more holistic proactive approach, rather than a reactive approach, can be taken.
lung cancer; epidemiology; smoking; tobacco
Mark Jaradeh,Wickii T. Vigneswaran. Epidemiology of lung cancer and the gender differences in risk. Journal of Men's Health. 2022. 18(3);1-10.
 Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fager-strom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. The New England Journal of Medicine. 2011; 365: 395–409.
 Harting FH HWDL. die Bergenkrankheit in den Schneeberger gruben. Vierteljahrsschrift für gerichtliche Medizin und öf-fentliches Sanitätswesen. 1879; 30: 296–309. (In Germany)
 Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA: a Cancer Journal for Clinicians. 2021; 71: 7–33.
 Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Es-timates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a Cancer Journal for Clinicians. 2021; 71: 209–249.
 Stapelfeld C, Dammann C, Maser E. Sex‐specificity in lung can-cer risk. International Journal of Cancer. 2020; 146: 2376–2382.
 Schabath MB, Cote ML. Cancer Progress and Priorities: Lung Cancer. Cancer Epidemiology Biomarkers & Prevention. 2019; 28: 1563–1579.
 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA: a Cancer Journal for Clinicians. 2018; 68: 7–30.
 Wong MCS, Lao XQ, Ho K, Goggins WB, Tse SLA. Incidence and mortality of lung cancer: global trends and association with socioeconomic status. Scientific Reports. 2017; 7: 14300.
 Bongaarts J. Human population growth and the demographic transition. Philosophical Transactions of the Royal Society B: Biological Sciences. 2009; 364: 2985–2990.
 de Groot PM, Wu CC, Carter BW, Munden RF. The epidemiol-ogy of lung cancer. Translational Lung Cancer Research. 2018; 7: 220–233.
 Barta JA, Powell CA, Wisnivesky JP. Global Epidemiology of Lung Cancer. Annals of Global Health. 2019; 85: 8.
 Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epi-demiology of Lung Cancer. Chest. 2013; 143: e1S–e29S.
 Wensink M, Alvarez J, Rizzi S, Janssen F, Lindahl-Jacobsen R. Progression of the smoking epidemic in high-income regions and its effects on male-female survival differences: a cohort-by-age analysis of 17 countries. BMC Public Health. 2020; 20: 39.
 Rafiemanesh H, Mehtarpour M, Khani F, Hesami SM, Shamlou R, Towhidi F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. Journal of Thoracic Disease. 2016; 8: 1094–1102.
 Islami F, Torre LA, Jemal A. Global trends of lung cancer mor-tality and smoking prevalence. Translational Lung Cancer Re-search. 2015; 4: 327–338.
 Zavala VA, Bracci PM, Carethers JM, Carvajal-Carmona L, Coggins NB, Cruz-Correa MR, et al. Cancer health disparities in racial/ethnic minorities in the United States. British Journal of Cancer. 2021; 124: 315–332.
 Stram DO, Park SL, Haiman CA, Murphy SE, Patel Y, Hecht SS, et al. Racial/Ethnic Differences in Lung Cancer Incidence in the Multiethnic Cohort Study: An Update. Journal of the National Cancer Institute. 2019; 111: 811–819.
 Haiman CA, Stram DO, Wilkens LR, Pike MC, Kolonel LN, Henderson BE, et al. Ethnic and racial differences in the smoking-related risk of lung cancer. The New England Journal of Medicine. 2006; 354: 333–342.
 Klugman M, Xue X, Hosgood HD. Race/ethnicity and lung can-cer survival in the United States: a meta-analysis. Cancer Causes & Control. 2019; 30: 1231–1241.
 Saeed AM, Toonkel R, Glassberg MK, Nguyen D, Hu JJ, Zim-mers TA, et al. The influence of Hispanic ethnicity on nonsmall cell lung cancer histology and patient survival: an analysis of the Survival, Epidemiology, and End Results database. Cancer. 2012; 118: 4495–4501.
 Houston KA, Mitchell KA, King J, White A, Ryan BM. His-tologic Lung Cancer Incidence Rates and Trends Vary by Race/Ethnicity and Residential County. Journal of Thoracic On-cology. 2018; 13: 497–509.
 Devesa SS, Diamond EL. Socioeconomic and racial differences
 Williams RR, Horm JW. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the third National Cancer Survey. Journal of the National Cancer Institute. 1977; 58: 525–547.
 Hovanec J, Siemiatycki J, Conway DI, Olsson A, Stücker I, Guida F, et al. Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS ONE. 2018; 13: e0192999.
 Ebner PJ, Ding L, Kim AW, et al. The Effect of Socioeconomic Status on Treatment and Mortality in Non-Small Cell Lung Can-cer Patients. The Annals of Thoracic Surgery. 2020;109(1):225-232.
 Williams DR, Priest N, Anderson N. Understanding Associa-tions between Race, Socioeconomic Status, and Health: Patterns and Prospects. In Oberlander J, Buchbinder M, Churchill LR, et al. (eds.) The Social Medicine Reader, Volume II, Third Edition (pp. 258–267). Duke University Press, Durham. 2020.
 King TE, Brunetta P. Racial disparity in rates of surgery for lung cancer. The New England Journal of Medicine. 1999; 341: 1231–1233.
 Raz DJ, Wu GX, Consunji M, Nelson RA, Kim H, Sun C, et al. The Effect of Primary Care Physician Knowledge of Lung Cancer Screening Guidelines on Perceptions and Utilization of Low-Dose Computed Tomography. Clinical Lung Cancer. 2018; 19: 51–57.
 Steiling K, Loui T, Asokan S, Nims S, Moreira P, Rebello A, et al. Age, Race, and Income are Associated with Lower Screening Rates at a Safety Net Hospital. The Annals of Thoracic Surgery. 2020; 109: 1544–1550.
 Kumar P, Gareen IF, Lathan C, Sicks JD, Perez GK, Hyland KA, et al. Racial Differences in Tobacco Cessation and Treatment Usage after Lung Screening: An Examination of the National Lung Screening Trial. The Oncologist. 2016; 21: 40–49.
 Han SS, Chow E, ten Haaf K, Toumazis I, Cao P, Bastani M, et al. Disparities of National Lung Cancer Screening Guidelines in the US Population. Journal of the National Cancer Institute. 2020; 112: 1136–1142.
 Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epi-demiology, Biomarkers & Prevention. 2010; 19: 1893–1907.
 Youlden DR, Cramb SM, Baade PD. The International Epidemi-ology of Lung Cancer: geographical distribution and secular trends. Journal of Thoracic Oncology. 2008; 3: 819–831.
 Thun MJ, Carter BD, Feskanich D, Freedman ND, Prentice R, Lopez AD, et al. 50-year trends in smoking-related mortality in the United States. The New England Journal of Medicine. 2013; 368: 351–364.
 Warner KE. The role of research in international tobacco control. American Journal of Public Health. 2005; 95: 976–984.
 Kamangar F, Dores GM, Anderson WF. Patterns of cancer inci-dence, mortality, and prevalence across five continents: defin-ing priorities to reduce cancer disparities in different geographic regions of the world. Journal of Clinical Oncology. 2006; 24: 2137–2150.
 Janssen-Heijnen ML, Coebergh JW. Trends in incidence and prognosis of the histological subtypes of lung cancer in North America, Australia, New Zealand and Europe. Lung Cancer. 2001; 31: 123–137.
 Jha P. Avoidable global cancer deaths and total deaths from smoking. Nature Reviews. Cancer. 2009; 9: 655–664.
 Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, et al. Challenges to effective cancer control in China, India, and Russia. The Lancet. Oncology. 2014; 15: 489–538.
 Kanwal M, Ding X, Cao Y. Familial risk for lung cancer. On-cology Letters. 2017; 13: 535–542.
 Cheung CHY, Juan H. Quantitative proteomics in lung cancer. Journal of Biomedical Science. 2017; 24: 37.
 Villalobos P, Wistuba II. Lung Cancer Biomarkers. Hematol-ogy/Oncology Clinics of North America. 2017; 31: 13–29.
 Walser T, Cui X, Yanagawa J, Lee JM, Heinrich E, Lee G, et al. Smoking and lung cancer: the role of inflammation. Proceedings of the American Thoracic Society. 2008; 5: 811–815.
 O’Keeffe LM, Taylor G, Huxley RR, Mitchell P, Woodward M, Peters SAE. Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis. BMJ Open. 2018; 8: e021611.
 Bade BC, Dela Cruz CS. Lung Cancer 2020: Epidemiology, Eti-ology, and Prevention. Clinics in Chest Medicine. 2020; 41: 1–24.
 Wynder EL, Hoffmann D. Smoking and lung cancer: scientific challenges and opportunities. Cancer Research. 1994; 54: 5284–5295.
 Peto R, Darby S, Deo H, Silcocks P, Whitley E, Doll R. Smok-ing, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. British Medical Journal. 2000; 321: 323–329.
 Hegmann KT, Fraser AM, Keaney RP, Moser SE, Nilasena DS, Sedlars M, et al. The effect of age at smoking initiation on lung cancer risk. Epidemiology. 1993; 4: 444–448.
 Leffondré K, Abrahamowicz M, Xiao Y, Siemiatycki J. Mod-elling smoking history using a comprehensive smoking index: application to lung cancer. Statistics in Medicine. 2006; 25: 4132–4146.
 Remen T, Pintos J, Abrahamowicz M, Siemiatycki J. Risk of lung cancer in relation to various metrics of smoking history: a case-control study in Montreal. BMC Cancer. 2018; 18: 1275.
 Tindle HA, Stevenson Duncan M, Greevy RA, Vasan RS, Kundu S, Massion PP, et al. Lifetime Smoking History and Risk of Lung Cancer: Results from the Framingham Heart Study. Journal of the National Cancer Institute. 2018; 110: 1201–1207.
 Thomson B, Emberson J, Lacey B, Lewington S, Peto R, Islami
F. Association of Smoking Initiation and Cessation across the Life Course and Cancer Mortality. JAMA Oncology. 2021; 7: 1901–1903.
 Christensen CH, Rostron B, Cosgrove C, Altekruse SF, Hartman AM, Gibson JT, et al. Association of Cigarette, Cigar, and Pipe Use with Mortality Risk in the US Population. JAMA Internal Medicine. 2018; 178: 469–476.
 Powell HA, Iyen-Omofoman B, Hubbard RB, Baldwin DR, Tata LJ. The association between smoking quantity and lung cancer in men and women. Chest. 2013; 143: 123–129.
 Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, et al. Vaping and lung cancer–A review of current data and recommendations. Lung Cancer. 2021; 153: 11–20.
 Lauterstein D, Hoshino R, Gordon T, Watkins B, Weitzman M, Zelikoff J. The changing face of tobacco use among United States youth. Current Drug Abuse Reviews. 2014; 7: 29–43.
 Kasza KA, Ambrose BK, Conway KP, Borek N, Taylor K, Go-niewicz ML, et al. Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014. The New England Journal of Medicine. 2017; 376: 342–353.
 Jones K, Salzman GA. The Vaping Epidemic in Adolescents. Missouri Medicine. 2020; 117: 56–58.
 Miech R, Johnston L, O’Malley PM, Bachman JG, Patrick ME. Trends in Adolescent Vaping, 2017–2019. The New England Journal of Medicine. 2019; 381: 1490–1491.
 Cullen KA, Gentzke AS, Sawdey MD, Chang JT, Anic GM, Wang TW, et al. E-Cigarette Use among Youth in the United States, 2019. JAMA. 2019; 322: 2095–2103.
 Villarroel MA. Electronic Cigarette Use Among U.S. Adults, 2018. NCHS Data Brief. 2020; 1–8.
 Nadhiroh S, Djokosujono K, Utari DM. The association between secondhand smoke exposure andgrowth outcomes of children: A systematic literature review. Tobacco Induced Diseases. 2020; 18: 12.
 Tsai J, Homa DM, Gentzke AS, Mahoney M, Sharapova SR, Sosnoff CS, et al. Exposure to Secondhand Smoke among Non-smokers - United States, 1988–2014. Morbidity and Mortality Weekly Report. 2018; 67: 1342–1346.
 Subramanyam R, Tapia IE, Zhang B, Mensinger JL, Garcia-Marcinkiewicz A, Jablonka DH, et al. Secondhand Smoke ex-posure and risk of Obstructive Sleep Apnea in Children. Inter-national Journal of Pediatric Otorhinolaryngology. 2020; 130: 109807.
 Bandiera FC, Richardson AK, Lee DJ, He J, Merikangas KR. Secondhand smoke exposure and mental health among children and adolescents. Archives of Pediatrics & Adolescent Medicine. 2011; 165: 332–338.
 Jett J, Stone E, Warren G, Cummings KM. Cannabis Use, Lung Cancer, and Related Issues. Journal of Thoracic Oncology. 2018; 13: 480–487.
 Callaghan RC, Allebeck P, Sidorchuk A. Marijuana use and risk of lung cancer: a 40-year cohort study. Cancer Causes & Con-trol. 2013; 24: 1811–1820.
 Lapham GT, Lee AK, Caldeiro RM, McCarty D, Browne KC, Walker DD, et al. Frequency of Cannabis Use among Primary Care Patients in Washington State. Journal of the American Board of Family Medicine. 2017; 30: 795–805.
 Zhang LR, Morgenstern H, Greenland S, Chang S, Lazarus P, Teare MD, et al. Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium. Interna-tional Journal of Cancer. 2015; 136: 894–903.
 Ghasemiesfe M, Barrow B, Leonard S, Keyhani S, Korenstein
D. Association between Marijuana Use and Risk of Cancer: A Systematic Review and Meta-analysis. JAMA Network Open. 2019; 2: e1916318.
 Cole P. Cancer and occupation: status and needs of epidemio-logic research. Cancer. 1977; 39: 1788–1791.
 Rushton L, Hutchings S, Brown T. The burden of cancer at work: estimation as the first step to prevention. Occupational and En-vironmental Medicine. 2008; 65: 789–800.
 Malhotra J, Malvezzi M, Negri E, La Vecchia C, Boffetta P. Risk factors for lung cancer worldwide. The European Respiratory Journal. 2016; 48: 889–902.
 Olsson AC, Gustavsson P, Zaridze D, Mukeriya A, Szeszenia-Dabrowska N, Rudnai P, et al. Lung cancer risk attributable to occupational exposures in a multicenter case-control study in Central and Eastern Europe. Journal of Occupational and En-vironmental Medicine. 2011; 53: 1262–1267.
 Jung JKH, Feinstein SG, Palma Lazgare L, Macleod JS, Arran-dale VH, McLeod CB, et al. Examining lung cancer risks across different industries and occupations in Ontario, Canada: the es-tablishment of the Occupational Disease Surveillance System. Occupational and Environmental Medicine. 2018; 75: 545–552.
 Boffetta P, Tubiana M, Hill C, Boniol M, Aurengo A, Masse R, et al. The causes of cancer in France. Annals of Oncology. 2009; 20: 550–555.
 Malhotra J, Sartori S, Brennan P, Zaridze D, Szeszenia-Dabrowska N, Świątkowska B, et al. Effect of occupa-tional exposures on lung cancer susceptibility: a study of gene-environment interaction analysis. Cancer Epidemiology, Biomarkers & Prevention. 2015; 24: 570–579.
 Klebe S, Leigh J, Henderson DW, Nurminen M. Asbestos, Smoking and Lung Cancer: An Update. International Journal of Environmental Research and Public Health. 2019; 17: 258.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.
SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)
Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.
Scopus: CiteScore 0.7 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).