Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Chapter 1 – Epidemiology, pathogenesis and risk factors


  • Lung cancer is the leading cause of cancer-related death worldwide in both genders
  • USA incidence rates in both genders increased until the 1990s and began to decline later, similar to the trend in mortality
  • In Europe, lung cancer-related deaths in women are secondary only to breast cancer and, in contrast to the USA scenario, the mortality rate continues to increase
  • Worldwide, every year, as many people die from lung cancer as from the other ‘big killers’ (prostate, breast, and colon cancer) combined
  • Only 15% of all lung cancer cases are diagnosed at an early stage, while the majority present with distant metastases at diagnosis and a 5-year survival rate of about 5%
  • Median age at diagnosis is 71 years and adenocarcinoma is now the most prevalent histotype
  • Lung cancer may arise from all the differentiated and undifferentiated cells of the upper and lower airways. The formation of DNA adducts as a consequence of the inhalation of carcinogens plays a central role in lung cancer pathogenesis
  • Lung cancer pathogenesis is also affected by a genetic multifactorial susceptibility, which may be further influenced by exposure to certain carcinogens
  • Smoking is the principal risk factor for lung cancer, causing more than 80% of all cases
  • Non-smoking-related risk factors include occupational exposure to carcinogens, second-hand smoke, pollution, dietary factors, radon exposure and genetic susceptibility

Further Reading

Boffetta P. Classic epidemiology of lung cancer. Chapter 3 in: Multidisciplinary Approach to Thoracic Oncology. Aurora, Colorado: IASLC Press, 2014.

Couraud S, Zalcman G, Milleron B, et al. Lung cancer in never smokers – a review. Eur J Cancer 2012; 48:1299–1311.

Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 2011; 32:605–644.

Didkowska J, Wojciechowska U, Mańczuk M, Lobaszewski J. Lung cancer epidemiology: contemporary and future challenges worldwide. Ann Transl Med 2016; 4:150.

Ferlay J, Colombet M, Soerjomataram I, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 European countries and 25 major cancers in 2018. Eur J Cancer 2018; 103:356–387.

Gazdar AF, Zhou C. Lung cancer in never smokers: a different disease. Chapter 4 in: Multidisciplinary Approach to Thoracic Oncology. Aurora, Colorado: IASLC Press, 2014.

Hashim D, Boffetta P, La Vecchia C, et al. The global decrease in cancer mortality: trends and disparities. Ann Oncol 2016; 27:926–933. Malhotra J, Malvezzi M, Negri E, et al. Risk factors for lung cancer worldwide. Eur Respir J 2016; 48:889–902.

Nielsen LS, Bælum J, Rasmussen J, et al. Occupational asbestos exposure and lung cancer – a systematic review of the literature. Arch Environ Occup Health 2014, 69:191–206.

Novello S, Stabile LP, Siegfried JM. Gender-related differences in lung cancer. Chapter 5 in: Multidisciplinary Approach to Thoracic Oncology. Aurora, Colorado: IASLC Press, 2014.

Pallis GA, Syrigos KN. Lung cancer in never smokers: disease characteristics and risk factors. Crit Rev Oncol Hematol 2013; 88:494–503.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69:7–34.

Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers – a different disease. Nat Rev Cancer 2007; 7:778–790.

Torres-Durán M, Barros-Dios JM, Fernández-Villar A, Ruano-Ravina A. Residential radon and lung cancer in never smokers. A systematic review. Cancer Lett 2014; 345:21–26.

Risk factors

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.