lung carcinoma

Last edited 03/2023 and last reviewed 07/2023

Over 46,000 people were diagnosed with lung cancer in the UK in 2015

• estimated 89% of lung cancers are preventable, with 86% of these linked to smoking, 13% to occupational exposure, 9% to dietary factors and 7.8% to air pollution
  • lung cancer can be linked to more than one cause
    
    
• in 2015 in the UK, over 35,000 people died from lung cancer
  • overall mortality rate from lung cancer has decreased by 9% over the last decade
  • however, while there has been a decrease of 19% in mortality rates in men, there has been an increase of 2% in women
    • linked to lifestyle factors such as smoking and is driven by an increased incidence of lung cancer in older women
      
      
• in the UK, lung cancer is more common in people of European family origin than in people of African or Asian family origin. It is strongly linked to socioeconomic deprivation. There are many risk factors for lung cancer, including age, genetics, lifestyle (especially smoking) and occupation

Lung cancer is diagnosed and staged using a variety of tests, including chest X-rays, CT or positron emission tomography CT (PET-CT)

• lung cancer samples are commonly acquired for diagnosis using bronchoscopy, endobronchial ultrasound (EBUS) or a percutaneous procedure (guided by CT or ultrasound).

Lung cancer has 2 main types:

• non-small-cell lung cancer (NSCLC), which is more common and spreads more slowly
• small-cell lung cancer (SCLC), which is rarer and spreads more quickly

Treatment depends on the type, size, position and stage of the cancer, and the person's health. Possible treatments include radiotherapy, systemic anti-cancer therapies, surgery, supportive care cryotherapy, photodynamic therapy and ablation

Survival (2):

• survival statistics are available for each stage of lung cancer in England
  • figures are for people diagnosed between 2013 and 2017
  • statistics are non-age-standardised which means they don't take into account the age of the people with lung cancer
• stage 1
  • more than 55 out of 100 people (more than 55%) with stage 1 lung cancer will survive their cancer for 5 years or more after they’re diagnosed.
• stage 2
  • around 35 out of 100 people (around 35%) with stage 2 lung cancer will survive their cancer for 5 years or more after they’re diagnosed. 
• stage 3
  • almost 15 out of 100 people (almost 15%) with stage 3 lung cancer will survive their cancer for 5 years or more after they’re diagnosed. 
• stage 4
  • almost 5 out of 100 people (almost 5%) with stage 4 lung cancer will survive their cancer for 5 years or more after they’re diagnose
    
    
• generally for people with lung cancer in England:
  • around 40 out of every 100 people (around 40%) survive their cancer for 1 year or more
  • around 15 out of every 100 people (around 15%) will survive their cancer for 5 years or more
  • 10 out of every 100 people (10%) will survive their cancer for 10 years or more

Smoking cessation after diagnosis materially improved overall and progression-free survival among current smokers with early-stage lung cancer (3)

• prospective Russian cohort study found higher overall survival time among patients who quit smoking vs continued smoking (6.6vs4.8yrs, respectively; P=0.001), 5-year overall survival (60.6%vs48.6%; P=0.001) and progression-free survival (54.4%vs43.8%; P=0.004)

Reference:

• NICE (March 2023). Lung cancer: diagnosis and management
• Cancer Research UK. Lung Cancer: lung cancer survival (Accessed 17/3/23)
• Mahdi Sheikh, Anush Mukeriya, Oxana Shangina, et al. Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality: A Prospective Cohort Study. Ann Intern Med. [Epub ahead of print 27 July 2021]. doi:10.7326/M21-0252
• Office for National Statistics Cancer Survival in England: adult, stage at diagnosis and childhood patients followed up to 2018, 2019. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancersurvivalinengland/latest