Lung Cancer

Lung cancer tumors are divided into two broad histological categories: non-small cell lung carcinoma (NSCLC) and small-cell lung carcinoma (SCLC). NSCLC represents more than 80 to 85% of lung cancers of which approximately 40% are adenocarcinoma, 25 to 30% are squamous cell carcinoma, and 10 to 15% are large cell carcinomas.
Survival rates are grouped based on the stage, but additional factors, including cell type (NSCLC vs. SCLC), the presence of actionable mutations, age, and comorbidities can also affect treatment outlook. The 5-year relative survival rate for lung cancer is 19.4% (16% for men and 22% for women) and is higher for NSCLC (23%) than for SCLC (6%).  The low survival rate reflects the fact that the majority of patients with lung cancer are diagnosed with advanced stages of disease. However, local therapy for early stage disease is associated with substantially improved overall survival.

Since 2011 evidence has been accumulated in favour of lung cancer screening trough low-dose helical computed tomography (LDCT). The introduction of a screening strategy is associated with a favorable stage shift from advanced to more early stage lung cancers.
The geographic and temporal patterns of lung cancer incidence, as well as lung cancer mortality, on a population level are mainly determined by tobacco consumption, the main aetiological factor in lung carcinogenesis. Other factors such as genetic susceptibility, poor diet, occupational exposures and air pollution may act independently or in concert with tobacco smoking in the pathofisiology of lung cancer.

Most patients will require multidisciplinary input over the course of their diagnosis and treatment. Development of multidisciplinary programs supported by members of the major disciplines involved in lung cancer care, namely the pulmonologist, thoracic surgeon, chest radiologist, pathologyst and the medical and radiation oncologists, is pivotal to ensure patients optimal treatment.
Major advances in lung cancer therapeutics include minimally invasive surgical techniques, refinements in radiotherapy, and a burgeoning of new systemic therapies targeting molecular pathways and the immune system.