Lung Cancer Flashcards
Lung cancer is the most frequent…
cause of cancer death in both males and females in North America.
What is the most common cancer in men and women? What is the most common cause of cancer death in men and women?
Most common cancer (women): breast cancer
Most common cancer (men): prostate cancer
Most common cause of cancer death: lung cancer (both men and women)
How has the huge decrease in smoking since the 1980s impacted lung cancer death rates in women?
Lung cancer death rates in women were increasing until 2008, but are now decreasing. This reflects the effect of stopping smoking in the 1980s.
Which is more deadly for women?
a) breast cancer
b) lung cancer
b) lung cancer (even though breast cancer is more common)
For never-smoking patients, is lung cancer more common in women or men?
The proportion of never-smoking patients with lung cancer is twice as high in women than in men
How do lung cancer survival rates compare between Indigenous and non-Indigenous patients?
5-year survival rates of Indigenous patients are 35% lower than non-Indigenous patients.
Compared to other circumpolar populations, which Arctic State has a significantly higher number of lung cancer cases per year?
Nunavut
Why do patients with lung cancer have such high death rates? (3)
- 75% of patients present with locally advanced or metastatic disease
- There is frequently and absence of symptoms in early stages
- Survival rates are low even in early stages of the disease
What is the overall 5 year survival rate for lung cancer?
20%
much lower than the 5-year survival rates of other cancers
How is lung cancer mortality rate currently changing (2023)?
In 2023, it was reported as decreasing by ~ 4% per year in males and in females. This is the fastest decline in lung cancer mortality reported to date in Canada, and largest decline in cancer mortality across all cancer types.
In recent years, the percentage of lung cancer patients living at least 3 years after diagnosis…
a) rose
b) fell
a) rose (from 19% to 31%)
What are the main causes of improving trends in terms of lung cancer mortality rates? (3)
- Decrease in tobacco use over the last 40 years
- Improvements in diagnostic and surgical procedures
- Improvements in therapies for stage 4 patients (driver mutations & immunotherapy)
Which cancer type has shown greater improvement in terms of survival rates?
a) small cell lung carcinoma (SCLC)
b) non-small cell lung carcinoma (NSCLC)
b) NSCLC
Name some risk factors for lung cancer (5)
- Cigarette smoking
- Prior lung radiation (breast cancer survivors)
- Scarring (from old TB, pulmonary fibrosis)
- Environmental exposures (work-related, second-hand smoke, air pollution)
- Genetic factors
Which lung cancer type is most strongly associated with cigarette smoking?
Small cell lung cancer
Globally, cigarette smoking by itself is responsible for … of all lung cancer cases
80%
What aspects of cigarette smoking affect risk of lung cancer? (6)
- number of cigarettes smoked
- duration
- age of starting
- degree of inhalation
- tar and nicotine content of cigarettes
- use of unfiltered cigarettes
What is a pack-year?
Number of packs of cigarettes smoked per day multiplied by the number of years smoked.
Example: Someone who has smoked 10 cigarettes per day (0.5 packs) for 40 years is. a 20 pack-year smoker.
How does the risk of lung cancer compare in patients who continue to smoke vs patients who have quit smoking?
The risk is greatly reduced after 10 years of quitting (the earlier you quit, the better)! However, it will never reach that of non-smokers.
Is second-hand smoke an important risk factor for lung cancer?
Yes! Living with a smoker is associated with a 20-30% increase in the risk of lung cancer.
Lung cancers in non-smokers are currently on the rise. What are some risk factors that may be responsible for this phenomenon? (6)
- Second-hand smoke
- Air pollution
- Occupation
- Exposure to radon
- Lung diseases (esp. parenchymal scarring due to lung fibrosis or old TB)
- Genetic factors
What are some occupational lung cancer exposures?
- Asbestos (pipe insulation, brakes, construction)
- Arsenic (batteries, paint, fertilizers)
- Radon (mining)
- Nickel
What cancer type is most commonly linked to asbestos exposure?
Mesothelioma
How does a combined exposure to asbestos and cigarette smoking alter the risk of developing lung cancer?
Cigarette smoking and asbestos exposure have a multiplicative effect.
Together, they increase the risk of lung cancer 20-50 times compared to a non-smoking, non-exposed individual.
Note: Smoking alone does not put you at risk of mesothelioma, but it has a compound effect in the case of asbestos exposure
