Lung Cancer in Never Smokers: A Review

2007 ◽  
Vol 25 (5) ◽  
pp. 561-570 ◽  
Author(s):  
Janakiraman Subramanian ◽  
Ramaswamy Govindan
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Growth Factor Receptor ◽  
The United States ◽  
Management Options ◽  
Relative Significance ◽  
Histologic Subtype ◽  
Molecular Abnormalities ◽  
Tk Inhibitors ◽  
Never Smokers

Lung cancer is the leading cause of cancer-related death in the United States. Although tobacco smoking accounts for the majority of lung cancer, approximately 10% of patients with lung cancer in the United States are lifelong never smokers. Lung cancer in the never smokers (LCINS) affects women disproportionately more often than men. Only limited data are available on the etiopathogenesis, molecular abnormalities, and prognosis of LCINS. Several etiologic factors have been proposed for the development of LCINS, including exposure to radon, cooking fumes, asbestos, heavy metals, and environmental tobacco smoke, human papillomavirus infection, and inherited genetic susceptibility. However, the relative significance of these individual factors among different ethnic populations in the development of LCINS has not been well-characterized. Adenocarcinoma is the predominant histologic subtype reported with LCINS. Striking differences in response rates and outcomes are seen when patients with advanced non–small-cell lung cancer (NSCLC) who are lifelong never smokers are treated with epidermal growth factor receptor tyrosine kinase (EGFR-TK) inhibitors such as gefitinib or erlotinib compared with the outcomes with these agents in patients with tobacco-associated lung cancer. Interestingly, the activating mutations in the EGFR-TK inhibitors have been reported significantly more frequently in LCINS than in patients with tobacco-related NSCLC. This review will summarize available data on the epidemiology, risk factors, molecular genetics, management options, and outcomes of LCINS.

scholarly journals Lung Cancer Mortality Among Smokers and Never-Smokers in the United States

Epidemiology ◽  
2020 ◽  
Vol 31 (3) ◽  
pp. e24-e25
Author(s):  
H. Dean Hosgood ◽  
Candace Cosgrove ◽  
Madelyn Klugman ◽  
Thomas Rohan ◽  
Sean Altekruse
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cancer Mortality ◽  
Lung Cancer Mortality ◽  
The United States ◽  
Never Smokers

scholarly journals The Role of DNA Methylation in the Development and Progression of Lung Adenocarcinoma

2007 ◽  
Vol 23 (1-2) ◽  
pp. 5-30 ◽  
Author(s):  
Keith M. Kerr ◽  
Janice S. Galler ◽  
Jeffrey A. Hagen ◽  
Peter W. Laird ◽  
Ite A. Laird-Offringa
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Dna Methylation ◽  
Lung Adenocarcinoma ◽  
Western Europe ◽  
Cpg Islands ◽  
The United States ◽  
Smoke Inhalation ◽  
Genetic Changes ◽  
Never Smokers

Lung cancer, caused by smoking in ∼87% of cases, is the leading cause of cancer death in the United States and Western Europe. Adenocarcinoma is now the most common type of lung cancer in men and women in the United States, and the histological subtype most frequently seen in never-smokers and former smokers. The increasing frequency of adenocarcinoma, which occurs more peripherally in the lung, is thought to be at least partially related to modifications in cigarette manufacturing that have led to a change in the depth of smoke inhalation. The rising incidence of lung adenocarcinoma and its lethal nature underline the importance of understanding the development and progression of this disease. Alterations in DNA methylation are recognized as key epigenetic changes in cancer, contributing to chromosomal instability through global hypomethylation, and aberrant gene expression through alterations in the methylation levels at promoter CpG islands. The identification of sequential changes in DNA methylation during progression and metastasis of lung adenocarcinoma, and the elucidation of their interplay with genetic changes, will broaden our molecular understanding of this disease, providing insights that may be applicable to the development of targeted drugs, as well as powerful markers for early detection and patient classification.

Changing Epidemiology of Small-Cell Lung Cancer in the United States Over the Last 30 Years: Analysis of the Surveillance, Epidemiologic, and End Results Database

2006 ◽  
Vol 24 (28) ◽  
pp. 4539-4544 ◽  
Author(s):  
Ramaswamy Govindan ◽  
Nathan Page ◽  
Daniel Morgensztern ◽  
William Read ◽  
Ryan Tierney ◽  
...  
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
The United States ◽  
Small Cell ◽  
Small Cell Lung ◽  
Modest Improvement ◽  
Histologic Subtype ◽  
End Results

Purpose Small-cell lung cancer (SCLC) is a histologic subtype of lung cancer with a distinct biology and clinical course. It has been observed that the incidence of SCLC has been decreasing over the last several years. Methods We used the Surveillance, Epidemiologic, and End Results (SEER) database to determine the incidence of SCLC over the last 30 years. In addition, we sought to determine sex- and stage-based differences in the incidence and survival of SCLC among a proportion of reported cases of lung cancer over the last 30 years (1973 to 2002). Joinpoint analyses were applied to test the trends in annual percentage change for statistical significance. Results The proportion of SCLC (among all lung cancer histologic types) decreased from 17.26% in 1986 to 12.95% in 2002. Of all patients with SCLC, the proportion of women with SCLC increased from 28% in 1973% to 50% in 2002. A modest but statistically significant improvement in 2- and 5-year survival was noted among both limited-stage SCLC and extensive-stage SCLC cohorts during the study period. Conclusion Our analysis indicates that the incidence of SCLC is decreasing in the United States, and only modest improvements have been seen in survival over the last 30 years. Possible explanations for the decreasing incidence include the decrease in the percentage of smokers and the change to low-tar filter cigarettes. Despite trends toward modest improvement in survival, the outcome remains very poor.

scholarly journals Cost-effectiveness and health impact of lung cancer screening with low-dose computed tomography for never smokers in Japan and the United States: a modelling study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Akiko Kowada
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cost Effectiveness ◽  
Lung Cancer Screening ◽  
Cost Effective ◽  
The United States ◽  
Sensitivity Analyses ◽  
Life Years ◽  
Never Smokers ◽  
Low Dose Computed Tomography

Abstract Background Never smokers in Asia have a higher incidence of lung cancer than in Europe and North America. We aimed to assess the cost-effectiveness of lung cancer screening with low-dose computed tomography (LDCT) for never smokers in Japan and the United States. Methods We developed a state-transition model for three strategies: LDCT, chest X-ray (CXR), and no screening, using a healthcare payer perspective over a lifetime horizon. Sensitivity analyses were also performed. Main outcomes were costs, quality-adjusted life-years (QALYs), life expectancy life-years (LYs), incremental cost-effectiveness ratios (ICERs), and deaths from lung cancer. The willingness-to-pay level was US$100,000 per QALY gained. Results LDCT yielded the greatest benefits with the lowest cost in Japan, but the ICERs of LDCT compared with CXR were US$3,001,304 per QALY gained for American men and US$2,097,969 per QALY gained for American women. Cost-effectiveness was sensitive to the incidence of lung cancer. Probabilistic sensitivity analyses demonstrated that LDCT was cost-effective 99.3–99.7% for Japanese, no screening was cost-effective 77.7% for American men, and CXR was cost-effective 93.2% for American women. Compared with CXR, LDCT has the cumulative lifetime potential for 60-year-old Japanese to save US$117 billion, increase 2,339,349 QALYs and 3,020,102 LYs, and reduce 224,749 deaths, and the potential for 60-year-old Americans to cost US$120 billion, increase 48,651 QALYs and 67,988 LYs, and reduce 2,309 deaths. Conclusions This modelling study suggests that LDCT screening for never smokers has the greatest benefits and cost savings in Japan, but is not cost-effective in the United States. Assessing the risk of lung cancer in never smokers is important for introducing population-based LDCT screening.

scholarly journals Exotic Haemaphysalis longicornis (Acari: Ixodidae) in the United States: Biology, Ecology, and Strategies for Management

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Brittany L Schappach ◽  
Rayda K Krell ◽  
Victoria L Hornbostel ◽  
Neeta P Connally
Keyword(s):  
United States ◽  
Vector Competence ◽  
The United States ◽  
United States Department ◽  
Haemaphysalis Longicornis ◽  
Life Stages ◽  
Department Of Agriculture ◽  
Management Options ◽  
Significant Public Health ◽  
Multiple Pathogens

Abstract The Asian longhorned tick (ALT), Haemaphysalis longicornis Neumann (Acari: Ixodidae), is a three-host tick that was first detected outside of United States Department of Agriculture (USDA) quarantine in Hunterdon County, New Jersey, in 2017 and subsequently found in another 14 states. In its native Asia, and where it has become established in Australia and New Zealand, ALTs feed on a variety of hosts and are economically important livestock pests and competent vectors of multiple pathogens to humans and other animals. The degree to which ALT will become a persistent livestock pest or competent vector for introduced or existing pathogens in the United States is yet unclear. Because of its vast host availability, ability to reproduce asexually, known vector competence, and the presence of multiple life stages on hosts, the expansion of ALT establishment in the United States is expected, and is a significant public health and veterinary concern. In this paper, we discuss the biology, geographical distribution, life cycle and seasonal activity, reproduction, identification, medical and veterinary implications, management options, and future concerns in the United States.

scholarly journals Rotating Night-Shift Work and Lung Cancer Risk Among Female Nurses in the United States

2013 ◽  
Vol 178 (9) ◽  
pp. 1434-1441 ◽  
Author(s):  
E. S. Schernhammer ◽  
D. Feskanich ◽  
G. Liang ◽  
J. Han
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Cancer Risk ◽  
Shift Work ◽  
Lung Cancer Risk ◽  
Night Shift ◽  
The United States ◽  
Night Shift Work ◽  
Female Nurses
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