Apart from smoking, an urban factor is an established risk factor for lung cancer. Lung cancer is associated with environmental factors, occupational exposure, bad habits and lifestyle factors. Approximately 17% of the annual deaths from lung cancer among adults are attributable to exposure to carcinogens located in the surface layer of the urban atmosphere, with industrial pollution and occupational hazards. According to recent data, 97% of cities in low- and middle-income countries with a population of more than 100 thousand people do not meet WHO recommendations for air quality; in high-income countries, this figure has been reduced to 49%. In the United States, the studies demonstrated that the prevalence of combined lung cancer was higher in urban areas (10.2%) than in rural areas (4.8%). There was a difference in the lung cancer incidence rates between the populations of the New York City and the New York State. In males, the lung cancer incidence rates were 1.4 times higher in the New York City than in the New York State (68.9 ± 1.2 0/0000 versus 48.5 ± 0.2 0/0000). In females, the lung cancer incidence rates were 1.2 times higher in the New York City than in the New York State (43.0 ± 0.3 and 34.9 ± 0.1 0/0000, respectively). In China, in urban areas, the lung cancer incidence mortality rates were 36.6 0/0000 and 28.9 0/0000, respectively. In rural areas, the corresponding values were 33.4 and 26.6 0/0000, respectively. Although the lung cancer incidence and mortality rates are higher in urban areas than in rural areas, these differences are gradually decreasing: the incidence rate between urban and rural areas has decreased from 2.1 to 1.1. The issue of the impact of environment on the incidence of lung cancer is challenging. The outdoor environment affects people’s health with varying degrees of intensity both in time and in space.
Patterns in lung cancer incidence rates and trends by histologic type in the United States, 2004–2009