《2010ESMO临床实践指南：转移性非小细胞肺癌》内容预览

incidence and epidemiology

Non-small-cell lung cancer (NSCLC) accounts for 80%–85% ofall lung cancer cases. Approximately 90% of lung cancersamong men and 80% among women are related to smoking.The majority of patients present with advanced disease. Theincidence differs considerably across different countries inEurope. The rates vary from 22 to 63 per 100 000 and from 5 to33/100 000 per year in men and women, respectively. In mostEuropean countries, the incidence continues to rise in womenbut decreases in men. This trend seems to occur later inSouthern and Eastern Europe than in the Northern regions.

Five-year age- and area-adjusted relative survival of all lungcancer patients in Europe continues to be low at 11%. CentralEuropean countries show slightly higher survival compared withother regions. Trends in lung cancer mortality in men havetended to decrease in many European countries during the lasttwo decades, particularly in North and Western Europe. Amongwomen, mortality rates are still increasing in many countries.

The major histopathological subtypes are adenocarcinoma,squamous cell carcinoma and large cell carcinoma. Again thereare variations across different regions mainly reflectingdifferent smoking behaviours. The proportion ofadenocarcinoma has been increasing over time possibly due tothe shift to low-tar filter cigarettes, which are inhaled moredeeply into the pe**hery of the lung and also contain a higheramount of nitrosureas. On the other hand, the incidence ofsquamous cell carcinoma is decreasing. A subset of NSCLCtumour specimens are also categorized as NSCLC not otherwisespecified (NOS), either due to small specimen size or poorlydifferentiated histology

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