Yaron Shargall, MD and Michael R. Johnston, MD, FRCSC, Division of Thoracic Surgery, Department of Surgery, University of Toronto; Division of Thoracic Surgery and Department of Surgical Oncology, Toronto General and Princess Margaret Hospitals, Toronto, ON.
Lung cancer is the leading cause of cancer death in Canada and the Western world. In the year 2001, it is estimated that 21,200 people in Canada will be diagnosed with lung cancer, and approximately 18,500 people will die as a result.1 Despite extensive research and clinical efforts, the survival rate has not changed appreciably over the past 30 years and remains poor, with an overall five-year survival of about 13%.2 Lung cancer is predominantly a disease of the elderly, since more than 60% of all lung cancer cases occur in people older than 60 years.3 There is overwhelming experimental and epidemiological data to support the contention that cigarette smoking is the primary risk factor for the development of lung cancer. Of all lung cancers in Canada, 85% are directly attributable to smoking, and another 3% may be caused by second-hand smoking.4 In this article, we summarize the current status of lung cancer screening and treatment, with special emphasis on the elderly population.
Screening for Lung Cancer
Lung cancer screening studies have not clearly demonstrated a reduction in mortality.