Chapter 1 – Epidemiology, pathogenesis and risk factors

Clinical features and survival expectancy

Clinical features and survival expectancy 1

Siegel R, et al. Ca Cancer J Clin 2019;69:7-34

Around only 15% of all lung cancer cases are diagnosed at an early stage, with a 5-year survival rate >50%.

In a large percentage of cases, lung cancer is diagnosed at an advanced stage with distant metastases and a 5-year survival rate of about 5%.

The 5-year survival rate for all lung cancer stages combined is about 18%.

Clinical features and survival expectancy 2

Dela Cruz CS, et al. Clin Chest Med 2011;32:605-644

Lung cancer in both sexes is predominantly diagnosed in the elderly population (median age at diagnosis is 71 years).

Compared with men, women are less likely to have a smoking history, are generally younger at the time of diagnosis, and have a better survival expectancy at any stage, independent of the therapeutic approach.

Lung adenocarcinoma is the most common histological subtype among women.

Adenocarcinoma accounts for 38.5% of all lung cancer cases, while squamous cell carcinoma and large cell carcinoma account for 20.0% and 2.9%, respectively.

Over the past decades, adenocarcinoma incidence has progressively increased, and it has now replaced squamous cell carcinoma as the most prevalent non-small cell lung cancer histotype.

Clinical features and survival expectancy 3

Dela Cruz CS, et al. Clin Chest Med 2011;32:605-644

Lung adenocarcinoma is also the most represented histotype among never-smokers.

Revision Questions

  1. What is the proportion of patients with lung cancer diagnosed at early stage of disease?
  2. Is there a correlation between a clinical characteristic (such as female gender or smoking attitude) and one specific histotype?
  3. Is the subtype histology prevalence the same compared with 30 years ago?
European scenario Pathogenesis of lung cancer

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