Lung Cancer

Kenneth Albert, MD
Lung cancer is not the most common cancer in either men or women. Prostate cancer is certainly number one in men and breast cancer is number one in women. It cuts lung cancer at approximately half; so you can see breast cancer is much more common than lung cancer. However, if you look at the deaths from cancer, lung cancer, it is by far the biggest killer in both men and women.
If you look at the changing incidence of lung cancer in men, the United Kingdom is actually decreasing quite substantially from the earlier 1960s and '70s. In the United States, it actually leveled off in the 1980s, and it has started to decline in the last couple of years, and in France it is still rising. So it really just depends on where you are and on your habits. In women, the United States is still going up. It hasn't showed any sign of leveling off. The United Kingdom has already leveled off and started to decline a little bit. In France, it is has always been low.
Types of lung cancer. There are two major types: non-small cell and small cell. Approximately 75-80% of the tumors that we see are non-small cell, while only 20-25% are small cell itself. If we look at the small cell subtypes, previously the vast majority of those particularly with the disease found in males was squamous cell cancer, but more recently the majority of them are adenocarcinomas, and 40% of all lung cancers are adenocarcinomas. So this has really shot up and changed the nature of the disease as well. Squamous cell is only 17% of all lung cancers.
In smokers, particularly males, squamous cell is a fairly predominant tumor type. But if we look at nonsmokers, adenocarcinoma is by far the most common subtype. The same is true of females, even to a greater extent. In smokers, adenocarcinoma is more common in females.
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