|Classification and external resources|
Three-dimensional volume rendering of a thorax CT showing a tumor in the lung (marked by arrow)
|eMedicine||med/1333 med/1336 emerg/335 radio/807 radio/405 radio/406|
The most common 
Survival depends on stage, overall health, and other factors. Overall, 15% of people in the United States diagnosed with lung cancer 
|Histological type||Incidence (per 100,000 per year)|
Non-small-cell lung carcinoma
Nearly 40% of lung cancers are adenocarcinoma, which usually originates in peripheral lung tissue.
Small-cell lung carcinoma
Four main histological subtypes are recognized, although some cancers may contain a combination of different subtypes.
The lung is a common place for metastasis of tumors from other parts of the body. Secondary cancers are classified by the site of origin; e.g., breast cancer that has spread to the lung is called metastatic breast cancer. Metastases often have a characteristic round appearance on chest radiograph.
|Squamous-cell carcinoma||CK5/6 positive
|Large-cell carcinoma||TTF-1 negative|
|Small-cell carcinoma||TTF-1 positive
Primary lung cancers themselves most commonly metastasize to the brain, bones, liver, and 
Signs and symptoms
Depending on the type of tumor, so-called 
Many of the symptoms of lung cancer (poor appetite, weight loss, fever, fatigue) are not specific.
Cancer develops following genetic damage to DNA. This genetic damage affects the normal functions of the cell, including cell proliferation, programmed cell death (apoptosis) and DNA repair. As more damage accumulates, the risk of cancer increases.
Outdoor air pollution has a small effect on increasing the risk of lung cancer.
Numerous other substances, occupations, and environmental exposures have been linked to the genesis of cancer in lung tissue of humans. In its List of Classifications by Cancer Sites,the International Agency for Research on Lung Cancer (IARC) states there is “sufficient evidence” to show the following are carcinogenic in lung:
- Aluminum production
- Arsenic and inorganic arsenic compounds
- Beryllium and beryllium compounds
- Bis-(chloromethyl) ether
- Methyl ether (technical grade)
- Cadmium and cadmium compounds
- Chromium(VI) compounds
- Coal (indoor emissions from household coal burning)
- Combustion (incomplete)
- Coal gasification
- Coal-tar pitch
- Coke production
- Diesel engine exhaust
- Gamma radiation
- Hematite mining (underground)
- Iron and steel founding
- MOPP (vincristine-prednisone-nitrogen mustard-procarbazine mixture)
- Nickel compounds
- Radon-222 and its decay products
- Rubber production industry
- Silica dust (crystalline)
- Sulfur mustard
Similar to many other cancers, lung cancer is initiated by activation of 
Performing a 
Lung cancer often appears as a 
The initial evaluation of non-small-cell lung cancer (NSCLC) staging uses the 
For both NSCLC and SCLC, the two general types of staging evaluations are clinical staging and surgical staging. Clinical staging is performed prior to definitive surgery. It is based on the results of imaging studies (such as CT scans and PET scans) and biopsy results. Surgical staging is evaluated either intra- or postoperatively, and is based on the combined results of surgical and clinical findings, including surgical sampling of thoracic lymph nodes.
Prevention is the most cost-effective means of mitigating lung cancer development. While in most countries, industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the prevention of lung cancer, and smoking cessation is an important preventive tool in this process.
Policy interventions to decrease 
The World Health Organization has called for governments to institute a total ban on tobacco advertising to prevent young people from taking up smoking. They assess that such bans have reduced tobacco consumption by 16% where instituted.
The long-term use of supplemental vitamin A,
If investigations confirm NSCLC, the 
In most cases of early-stage NSCLC, removal of a lobe of lung (
In SCLC, chemotherapy and/or radiotherapy is typically used.
For potentially curable SCLC cases, chest radiotherapy is often recommended in addition to chemotherapy.
If cancer growth blocks a short section of bronchus, 
Prophylactic cranial irradiation (PCI) is a type of radiotherapy to the brain, used to reduce the risk of metastasis. PCI is most useful in SCLC. In limited-stage disease, PCI increases three-year survival from 15% to 20%; in extensive disease, one-year survival increases from 13% to 27%.
Recent improvements in targeting and imaging have led to the development of stereotactic radiation in the treatment of early-stage lung cancer. In this form of radiotherapy, high doses are delivered in a small number of sessions using stereotactic targeting techniques. Its use is primarily in patients who are not surgical candidates due to medical comorbidities.
Small-cell lung carcinoma
Even if relatively early stage, SCLC is treated primarily with chemotherapy and radiation.
Non-small cell lung carcinoma
In advanced NSCLC, chemotherapy improves survival and is used as first-line treatment, provided the patient is well enough for the treatment.
Advanced NSCLC is often treated with 
Adjuvant chemotherapy for patients with stage IB cancer is controversial, as clinical trials have not clearly demonstrated a survival benefit.
In patients with terminal disease, palliative care or hospice management may be appropriate.
Chemotherapy may be combined with palliative care in the treatment of the NSCLC. In advanced cases, appropriate chemotherapy improves 
|Clinical stage||Five-year survival (%)|
|Non-small cell lung carcinoma||Small cell lung carcinoma|
Prognostic factors in NSCLC include presence or absence of pulmonary symptoms, 
Prognosis is generally poor. Of all patients with lung cancer, 15% survive for five years after diagnosis.
For NSCLC, the best prognosis is achieved with complete surgical resection of stage IA disease, with up to 70% five-year survival.
According to data provided by the 
Worldwide, lung cancer is the most common cancer in terms of both 
For every 3–4 million cigarettes smoked, one lung cancer death occurs.
The role of 
From the 1960s, the incidence of lung adenocarcinoma started to rise relative to other types of lung cancer. This is partly due to the introduction of filter cigarettes. The use of filters removes larger particles from tobacco smoke, thus reducing deposition in larger airways. However, the smoker has to inhale more deeply to receive the same amount of nicotine, increasing particle deposition in small airways where adenocarcinoma tends to arise.
Lung cancer was uncommon before the advent of cigarette smoking; it was not even recognized as a distinct disease until 1761.
The connection with 
The first successful 
With small-cell lung carcinoma, initial attempts in the 1960s at surgical resection
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