Epidemiology of lung cancer - Global and Indian perspective

D Behera

摘要

In the beginning of the twentieth century, lung cancerwas considered to be rare1. But now it has reachedepidemic proportions. It is the leading cause of cancerdeaths in developed countries and is rising at alarmingrates in the developing countr ies2. Estimates of theworldwide incidence and mortality from 27 cancers in2008 have been prepared for 182 countries as part of theGlobocan series published by the International Agencyfor Research on Cancer. Results for 20 world regions,summarising the global patterns for the eight mostcommon cancers have been made in this report. Overall,an estimated 12.7 million new cancer cases and 7.6 millioncancer deaths occurred in 2008, with 56% of new cancercases and 63% of the cancer deaths occurring in the lessdeveloped regions of the world. The most commonlydiagnosed cancers worldwide are lung (1.61 million,12.7% of the total), breast (1.38 million, 10.9%), andcolorectal cancers (1.23 million, 9.7%). The most commoncauses of cancer deaths are lung cancer (1.38 million,18.2% of the total), stomach cancer (738,000 deaths, 9.7%)and liver cancer (696,000 deaths, 9.2%). Cancer is neitherrare anywhere in the world, nor mainly confined to high-resource countries. Striking differences in the patterns ofcancer from region to region are observed3. In contrast tothe 5 years survival of 52% in all cancers, the lung cancersurvival rates continue to be poor4, 5.The age-adjusted lung cancer death rates in USA over aperiod of six decades shows a declining trend in maleswhereas the same in females shows a rising trend, mainlybecause of the declining smoking habits in males andincreasing smoking habits in females.Lung cancer in IndiaIn India, lung cancer was initially thought to beextremely rare1. Few attempts were made to know the var currentpos,timer; function initialize() { timer=setInterval("scrollwindow()",10);} function sc(){clearInterval(timer); }function scrollwindow() { currentpos=document.body.scrollTop; window.scroll(0,++currentpos); if (currentpos != document.body.scrollTop) sc();} document.onmousedown=scdocument.ondblclick=initialize132Journal, Indian Academy of Clinical Medicine zVol. 13, No. 2 zApril-June, 2012that of the 2,23,930 hospital admissions there were 863lung cancer cases (0.38%). Lung cancer was the fifthcommon cancer after lympho-reticular malignancy,carcinoma cervix, oropharyngeal cancer and carcinomaof breast. The total number of lung cancer admissionssteadily rose from 1973.As of 1st July 2002, a total of 41,000 lung cancer caseswould have been diagnosed as per data from the ICMRCancer Registry . Males predominate with a M:F ratio of4.5:1 and this ratio varies with age and smoking status.The ratio increases progressively upto 51 - 60 years andthen remains the same. The smoker to non-smoker ratiois high upto 20:1 in various studies. Upto 40 years of age,small-cell type predominates and has less association withsmoking. After the age of 40 years, squamous cell type iscommonest in smokers and adenocarcinoma in non-smokers. The demographic pattern of lung cancer in Indiais similar to that of Western countries 40 years ago. Theregional burden of lung cancer in the world is shown inTable I below3.The burden of lung cancer in India as reported in theGlobocan Report is shown in Table II.Table II: Lung cancer in IndiaIndiaMale Female Both sexesPopulation (thousands) 610618 570793 1181412Number of new cancer cases 430.1518.8948.9(thousands)Age-standardised rate (W) 92.9105.598.5Risk of getting cancer10.210.810.4before age 75 (%)Number of cancer deaths 321.4312.1633.5(thousand)Age-standardised rate (W) 71.265.568.0Risk of dying from cancer 8.07.17.5before age 75 (%)5 most frequent cancersLung Cervix uteri Cervix uteriLip, oral cavity Breast BreastOropharynx Ovary Lip, oral cavityOesophagus Lip, oral cavity LungStomach Oesophagus OesophagusTable I: The worldwide distribution of lung cancer.CLOBOCAN - 2008Estimated numbers (thousands)MenWomenBoth sexesCases Deaths Cases Deaths Cases DeathsWorld1,0959515134271,608 1,378More developed regions482411241188723599Less developed regions612539271239883778WHO Africa region (AFRO)1211441615WHO Americas region (PAHO)172144134101306245WHO East Mediterranean region (EMRO)2119542623WHO Europe reguib (EURO)31327810491417369WHO South-East Asia region (SEARO)108974237150134WHO Western Pacific region ( WPRO)465397222187687584IARC membership (21 countries)456386233180689566United States of America1149010071214161China351304170148521452India474111105851European Union (EU-27)2071828070287252

机译：在二十世纪初，肺癌被认为是罕见的。但是现在它已经达到流行病的程度。它是发达国家致死的主要原因，并且在发展中国家中以令人震惊的速度上升2。作为国际癌症研究机构发布的地球球系列研究的一部分，已经为182个国家/地区准备了2008年全球27种癌症的发病率和死亡率的估计值。本报告对20个世界地区的结果进行了总结，总结了八种最常见癌症的全球模式。总体而言，2008年估计有1270万例新癌症病例和760万例癌症死亡，其中56％的新癌症病例和63％的癌症死亡发生在世界欠发达地区。全世界最常见的癌症是肺癌（161万，占总数的12.7％），乳腺癌（138万，占10.9％）和结直肠癌（123万，占9.7％）。癌症死亡的最常见原因是肺癌（138万人，占总数的18.2％），胃癌（738,000例死亡，9.7％）和肝癌（696,000例死亡，9.2％）。癌症在世界任何地方都不是罕见的，也不主要局限于资源丰富的国家。观察到不同地区癌症模式的惊人差异3。与所有癌症的52％的5年生存率相比，肺癌的生存率仍然很差4、5。美国经过六十年的年龄调整后的肺癌死亡率显示出男性下降的趋势，而女性的下降趋势上升趋势主要是由于男性吸烟习惯的减少和女性吸烟习惯的增加。印度的肺癌最初在印度，肺癌被认为极为罕见1。很少有人尝试了解var currentpos，timer;函数initialize（）{timer = setInterval（“ scrollwindow（）”，10）;}函数sc（）{clearInterval（timer）; } function scrollwindow（）{currentpos = document.body.scrollTop; window.scroll（0，++ currentpos）; if（currentpos！= document.body.scrollTop）sc（）;} document.onmousedown = scdocument.ondblclick = initialize132Journal，印度临床医学科学院院报。 2012年4月6日至13日，在2,23,930例住院病例中，有863例肺癌病例（0.38％）。肺癌是仅次于淋巴网状恶性肿瘤，子宫颈癌，口咽癌和乳腺癌的第五大常见癌症。自1973年以来，肺癌的总住院人数稳步上升。根据ICMRCancer Registry的数据，截至2002年7月1日，总共已诊断出41,000例肺癌病例。男性以M：F为4.5：1为主，并且该比例随年龄和吸烟状况而变化。该比例在51至60岁之间逐渐增加，然后保持不变。在各种研究中，吸烟者与不吸烟者的比例高达20：1。到40岁时，小细胞型占主导地位，与吸烟的关联性降低。 40岁以后，鳞状细胞类型在吸烟者中最常见，而在非吸烟者中则是腺癌。印度肺癌的人口统计学特征与40年前的西方国家相似。世界肺癌的区域负担见下面的表I3。全球肺癌报告中报告的印度肺癌负担见表II。表II：印度的肺癌印度男性女性男女人口（千）610618 570793 1181412新发人数癌症病例430.1518.8948.9（千）年龄标准化率（W）92.9105.598.5 75岁之前得癌症的风险10.210.810.4（％）癌症死亡人数321.4312.1633.5（千）年龄标准化率（W）71.265。 568.0死于癌症的风险8.07.17.5在75岁之前（％）5最常见的癌症5子宫颈宫颈，子宫颈，口腔乳腺口咽子宫颈口腔，食道口腔，口腔肺食管食道食管表I：肺癌在全球的分布CAN。 -2008年估计人数（千）男性女性性别案例死亡案例死亡案例死亡案例世界1,959515134271,608 1,378其他发达地区482411241188723599较少发达地区612539271239883778世界卫生组织非洲地区n（AFRO）1211441615WHO美洲地区（PAHO）172144134101306245WHO东地中海地区（EMRO）2119542623WHO欧洲规制（EURO）31327810491417369WHO东南亚地区（SEARO）108974237150134WHO西太平洋地区（WPRO）465397222187687584IARC会员国（21个国家）美国100691654180473654170304197430447430419741 304165465413041654美国国家/地区（EU-27）2071828070287252

Epidemiology of lung cancer - Global and Indian perspective

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