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Flory Ann Evia, Paul John, Brett Seaholm, Caroline Yeager, Andrew Diehn
Epidemiology
Introduction
Lung cancer is the second most commonly occurring cancer in the United States and is the
leading cause of cancer related death. Lung cancer has been identified as a health disparity
by Healthy People 2020. The biggest risk factor lung cancer is smoking, causing
approximately 85% of lung cancer cases in the U.S. This analysis focused on non-small cell
lung cancer (NSCLC) due to high incidence and association with smoking. Lung cancer rates
vary by geographic region. A complete investigation of the effects of NSCLC was completed
for the state of Illinois and Kentucky.
Biology
Lung cancer causes malignant tumors to form in the lungs that destroy
healthy lung tissue and can spread to other areas of the body.
(NSCLC) accounts for 80 to 85% of all lung cancers and is classified by
adenocarcinoma (50%), squamous cell carcinoma (30 35%), and large
cell carcinoma (510%).
Lung cancers are usually asymptomatic until the disease is at an
advanced stage. NSCLC is often diagnosed at an advanced stage when
treatment options are limited.
Smoking is the leading cause of lung cancer with other causes being
environmental exposure and genetic factors. Genetic and epigenetic
factors develop lung cancer through activation of growth promoting
pathways and inhibition of tumour suppressor pathways.
Lung cancer screening through the use of low dose computed
tomographic can detect many tumours at early stages
Figure 3. Lung and bronchus cancer incidence rates for the United States. Kentucky has the highest
incidence rate (92.4). Illinois has an incidence rate of 65.8 per 100,000.
Kentucky has high rates of smoking among the adult population (25.2% of
the adult population)
Kentucky also has the highest percentage of youth smokers aged 12 to 18
(15.9%)
The majority of new lung cancer patients are elderly (median = 70yrs)
More men die from lung cancer than women.
Women have a higher risk of developing lung cancer versus men who
smoke the same amount.
The incidence of lung cancer in women has only recently fallen whereas
lung cancer incidence in men peaked in 1984.
Black men have higher incidence and mortality rates than any other racial
Logo for secondary institution
or ethnic group.
Illinois
Kentucky
3.1mil
2.5mil
3.1mil
2.3mil
6.2mil
4.7mil
136,700,00
56,400,000
Percentage of CDC
Recommended
4.5%
8.4%
1.1bil
302mil
Kentucky
Medications
Counseling
No Coverage
Barriers to Coverage
Medicaid Expansion
Yes
Yes
if appropriate
References
Figure 4. Lung and bronchus cancer incidence rates for Race/Ethnicity in the United States. Black men are
disproportionately affected by lung cancer at 90.9 new cases per 100,000 persons.
Cooper WA, Lam DCL, OToole SA, Minna JD. Molecular biology of lung cancer. J Thorac Dis 2013;5(S5):S479-S490. doi: 10.3978/ j.issn.20721439.2013.08.03
Huang, J & Chaloupka, FJ, The Impact of the 2009 Federal Tobacco Excise Tax Increase on Youth Tobacco Use, National Bureau of Economic
Research Working Paper 18026, April 2012
Meza, R., Meernik, C., Jeon, J., & Cote, M. L. (2015). Lung cancer incidence trends by gender, race and histology in the United States, 1973
2010. PloS one, 10(3), e0121323.
Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. (2011). New England Journal of Medicine N Engl J Med,
365(5), 395-409.
Refsgaard, B., & Frederiksen, K. (2013). Illness-Related Emotional Experiences of Patients Living With Incurable Lung Cancer: A Qualitative
Metasynthesis. Cancer Nursing An International Journal for Cancer Care, 36(3). doi:10.1097/NCC.0b013e318268f983