Harrison's Internal Medicine Chapter 85. Neoplasms of the Lung The Magnitude of the Problem In 2007, primary carcinoma of the lung affected 114,760 males and 98,620 females in the United States; 86% die within 5 years of diagnosis, making it the leading cause of cancer death in both men and women. The incidence of lung cancer peaks between ages 55 and 65 years. Lung cancer accounts for 29% of all cancer deaths (31% in men, 26% in women). Lung cancer is responsible for more deaths in the United States each year than breast cancer, colon cancer, and prostate cancer combined;. | Chapter 085. Neoplasms of the Lung Part 1 Harrison s Internal Medicine Chapter 85. Neoplasms of the Lung The Magnitude of the Problem In 2007 primary carcinoma of the lung affected 114 760 males and 98 620 females in the United States 86 die within 5 years of diagnosis making it the leading cause of cancer death in both men and women. The incidence of lung cancer peaks between ages 55 and 65 years. Lung cancer accounts for 29 of all cancer deaths 31 in men 26 in women . Lung cancer is responsible for more deaths in the United States each year than breast cancer colon cancer and prostate cancer combined more women die each year of lung cancer than of breast cancer. The age-adjusted lung cancer death rate in males is decreasing but in females it is stable or still increasing. These death rates are related to smoking smoking cessation efforts begun 40 years ago in men are largely responsible for the change in incidence and death rates. However women started smoking in substantial numbers about 10-15 years later than men smoking cessation efforts need to increase for women. The 5-year overall lung cancer survival rate 15 has nearly doubled in the past 30 years. The improvement is due to advances in combined-modality treatment with surgery radiotherapy and chemotherapy. The International Agency for Research on Cancer estimates that there will be over million deaths from lung cancer worldwide in 2007 which will rise to 10 million deaths per year by 2030. This represents one lung cancer case for every 3 million cigarettes smoked. Thus primary carcinoma of the lung is a major health problem with a generally grim prognosis. Pathology The term lung cancer is used for tumors arising from the respiratory epithelium bronchi bronchioles and alveoli . Mesotheliomas lymphomas and stromal tumors sarcomas are distinct from epithelial lung cancer. Four major cell types make up 88 of all primary lung neoplasms according to the World Health Organization classification Table 85-1 .