This review presents the latest available international data for lung cancer incidence,
mortality and survival, emphasizing the established causal relationship between smoking
and lung cancer. In 2002, it was estimated that 1.35 million people throughout the
world were diagnosed with lung cancer, and 1.18 million died of lung cancer-more than
for any other type of cancer. There are some key differences in the epidemiology of
lung cancer between more developed and less developed countries. In more developed
countries, incidence and mortality rates are generally declining among males and are
starting to plateau for females, reflecting previous trends in smoking prevalence.
In contrast, there are some populations in less developed countries where increasing
lung cancer rates are predicted to continue, due to endemic use of tobacco. A higher
proportion of lung cancer cases are attributable to nonsmoking causes within less
developed countries, particularly among women. Worldwide, the majority of lung cancer
patients are diagnosed after the disease has progressed to a more advanced stage.
Despite advances in chemotherapy, prognosis for lung cancer patients remains poor,
with 5-year relative survival less than 14% among males and less than 18% among females
in most countries. Given the increasing incidence of lung cancer in less developed
countries and the current lack of effective treatment for advanced lung cancers, these
results highlight the need for ongoing global tobacco reform to reduce the international
burden of lung cancer.