Although the incidence rate in men has declined slightly in recent years, it has continued to increase in women. Since 1987, more women have died yearly of lung cancer than of breast cancer. For people who smoke two or more packs of cigarettes a day, the mortality rate associated with lung cancer is 15 to 25 times greater than that for nonsmokers. Other risk factors include industrial exposures to agents such as asbestos, arsenic, uranium, nickel, and chromates as well as exposures to the indoor air pollutants such as formaldehyde and radon gas, which act as cocarcinogens.
Treatment depends on both the type and the stage of the disease.
Surgery, radiation therapy, and chemotherapy are all options. Surgery is usually the treatment of choice for non-small cell cancer when it is localized. However, in the majority of such cases, the tumor has spread beyond the primary site, so that radiation therapy and chemotherapy are often combined with surgery. In limited-stage small cell lung cancer, a combination of chemotherapy and radiation therapy has largely replaced surgery as the treatment of choice. Because such multimodality approaches are complex, thoracic surgeons, radiation oncologists, and medical oncologists must work together to provide optimal care to these patients.