3. Lung Cancer Epidemiology I Flashcards
What are the two types of lung cancer
What % do they make up each
Non-small cell 90-85%
Small cell 10-15%
List some examples of nonsmall cell lung carcinomas
- squamous cell
- adenocarcinomas
- large cell neuroendocrine
- adenosquamous
- carcinosarcoma
- pulmonary blastoma
List the different ways of ingesting tobacco that may have an effect on lung cancer
- smoking
- sniffing
- chewing
- cannabis smoking
- environmental tobacco smoke
List some examples of occupational causes of lung cancer
- Asbestos
- Arsenic - hazardous waste sites
- Beryllium - metal, ceramics, alloys, salts (mechanics)
- Cadmium - dust, fumes, mists
- Silica - construction (cutting, drilling, grinding, polishing)
List some examples of air pollution that cause lung cancer
- diesel fumes
- nitrogen oxide
- particulate matter
If a first degree relative has lung cancer independent of smoking, what is the increased family risk of lung cancer?
2-4 x
T or F:
Lung cancer is the..
1. Most common cancer in men
2. Second most common cancer in women
3. Most common cancer killer in both men and women
- F - it is the second most common (prostate 1st)
- T
- T
Describe the age-standardized incidence rate of lung cancer and smoking prevalence in men versus women in Europe since 1948
- Smoking prevalence percentage in both sexes has decreased
- Male lung cancer incidence has decreased
- Women lung cancer incidence has increased
Describe the ratio of male to female crude annual incidence in the UK from 1975 -> now, and the impact on the number of diagnoses a year
1975: 39:10
Now: 11:10
1000 extra diagnoses/year
Describe lung cancer incidence and mortality by age groups.
Incidence:
- median age: 73
- highest rates: 80-85
Mortality:
- median age 75
Highest rates: 85-89
Compare the SES/Area Deprivation to Incidence of Lung Cancer/ Cigarette Smoking Prevalence
More affluent areas have the lowest risk, less affluent areas have higher risk.
Cigarette smoking is most prevalent is more deprived areas, in both men and women
Compare % of NCIN routes to diagnosis and their 1 year survival %
- half of diagnoses are made from GP/2WW (2 week wait)
- 35% are through A&E, the rest are other
- 1 year survival is highest when diagnosed through GP/2WW (40%)
- Lowest when diagnosed through emergency (<10% 1 year survival)
List the symptoms and signs of lung cancer
- Persistent cough & dyspnoea (shortness of breath)
- Haemoptysis (coughing blood) & hoarse voice with bovine cough
- recurrent chest infections & chest pain
- fatigue, loss of appetite, weight loss
- clubbing (finger ends swelling, only NSCLC)
- monophonic wheeze, narrowed airway
- swelling of face/neck - SVCO (superior vena cava obstruction)
- Pain elsewhere & neurological signs (metastasis)
- Pleural effusion & lung collapse
What does the NICE NG122 suggest about investigation
Choose investigations that give maximum diagnostic and staging information with least risk
Briefly outline the investigation and work up for a lung cancer patient from day -3 to day 30
-3: CRX (Chest X-Ray)
0: CT scan, clinic, PET-CT
4-15: Diagnostic & staging bundle: lung function, walk test, lung biopsy, specialist nurse, smoking cessation, medical optimization of COPD
18: MDT meeting, meet surgeon & patient-accepted surgery
30: surgery, VATS lobectomy, T1b N0 M0 R0 staging
