|
Number of deaths
10000
8000
6000
4000
2000
0
Lung cancer Colorectal cancer
Pancreati c cancer
Figure 1 . Estimated cancer mortality in Australia ( 2022 ).
|
Prostate cancer |
Breast cancer |
Unknown Liver cancer primary site |
Source : AIHW 2022 4 |
Box 1 . Risk factors for lung cancer
• Lifestyle / behavioural factors : — Active tobacco smoking . — Former tobacco smoking .
• Environmental / occupational exposure : — Passive tobacco smoking . — Radon . — Asbestos . — Arsenic , cadmium , nickel , chromium IV . — Diesel exhaust . — Silica . — Air pollution . — Iron and steel workers , painters .
• Personal / family history : — Increased age . — History of chronic lung disease : COPD , pulmonary fibrosis , emphysema , chronic bronchitis , asthma , pneumonia , tuberculosis . — HIV infection . — Family history of lung cancer . — Certain gene mutations .
Source : Schabath MB et al 2019 1 , Cancer Australia 2019 8 , Cancer Australia 2020 11 , Cancer Australia 2014 13
|
|
A
4000
29 %
3000
2000
12 % 11 %
1000
7 %
0 I II III IV Unknown
Stage at diagnosis
Figure 2 . Lung cancer incidence and survival .
Number of cases
A . Lung cancer ( C33-C34 in ICD classification ) incidence ( 2011 ).
42 %
|
B
Survival (%)
80
60
40
20
0
|
68 %
32 %
17 % 14 %
3 %
|
Sources : AIHW 2022 4 , Cancer Australia 2018 6 , Cancer Australia 2019 8 |
0 |
1989-93 1994-98 1999-03 2004-08 2009-13 2014-18 |
0 |
1989-93 1994-98 1999-03 2004-08 2009-13 2014-18 |
All persons Males Females |
All persons Males Females |
|
by tumour biomarkers and genetic
alterations . 1 Improvements for patients with SCLCs have been limited com-
|
per 100,000 persons ( 49 for males and 39 for females ). 9 NSCLC accounts for about 85 % of all lung cancers , with |
in rural or remote parts of Australia or do not have the financial means to be properly screened and staged ”. 4 |
and adenocarcinoma — varies , and this has been observed over time with the changes in cigarette design |
— particularly in younger adults and non-smokers — vaping may have significant future implications . 15 |
pared with those who have NSCLCs , |
SCLC making up the remaining 15 %. 1 |
The risk factors associated with |
increasing the risk of smoking-related |
Long-term cannabis smoking also |
where recent advances in staging and |
Aboriginal and Torres Strait Islander |
developing lung cancer can be grouped |
adenocarcinoma . 12 |
increases the risk of lung cancer in |
surgery , and the availability of targeted |
people are twice as likely to be diag- |
into three main areas : lifestyle or |
About 90 % of lung cancers in |
young adults , with one study find- |
|
drugs and immunotherapy , can help improve survival at every stage . 7
This How to Treat provides a guide to help GPs identify at-risk individuals ; an overview of diagnosis and refer-
|
nosed with and die from lung cancer . 10 In addition , five-year survival rates in this population are lower in comparison with non-Indigenous Australians . 11 Furthermore , incidence and mortal- |
behaviours , environmental or occupational exposures , and personal and family history ( see box 1 ).
According to current estimates , the risk of being diagnosed with lung
|
males and 65 % in females are thought to be related to smoking . 11 The relative risk ( RR ) of developing lung cancer increases with factors such as the amount smoked , duration of smoking , |
ing that one cannabis joint is similar to about 20 cigarettes for risk of lung cancer . 16 Differences in lung cancer risks may be related to the fact that cannabis joints are usually smoked without a fil- |
ral in the primary care setting ; and a |
ity increase with remoteness / distance |
cancer by the age of 85 is 1 in 20 , with |
earlier age of starting to smoke , ciga- |
ter , to a smaller butt size with deeper |
summary of the current treatments |
from a metropolitan centre and are |
males at slightly greater risk ( 1 in 19 ) |
rette tar level and butt length ( fraction |
and longer inhalation techniques , along |
|
and management for individuals with lung cancer .
EPIDEMIOLOGY AND AETIOLOGY
LUNG cancer is the fifth most commonly
diagnosed cancer in Australia ( see table 1 ), with an estimated 14,529 new cases identified in 2022 . 4 The age-standardised incidence rate ( ASR )
|
highest in those living in lower socioeconomic areas . 11 The higher prevalence of risk factors , such as cigarette smoking , may explain the higher lung cancer rates , with poorer outcomes also influenced by poorer access to the full range of health services and treatments .
According to Mark Brooke , CEO of Lung Foundation Australia , “ lung cancer is still a disease of inequity of
|
and females at a lower risk ( 1 in 21 ). 9
Tobacco smoking is the most significant single cause of lung cancer . 11 Its strong association with smoking has been known for some time ( being clearly documented as far back as the 1930s ). The link is evident for all lung cancer types and is dose-related . 12 However , the relationship between smoking and two major types of lung
|
smoked ) and decreases with time since quitting ( see box 2 ). 12
There is increasing concern that e-cigarette use , or “ vaping ”, may also increase lung cancer risk . 14 Although it seems that e-cigarette consumption is less toxic than tobacco smoking , harmful effects from short-term use have been described . E-cigarettes contain both definite and probable
|
with the differences in chemical composition between cannabis and cigarette smoke . 16 However , evidence for a causal association between cannabis and lung cancer is limited and conflicting , and while the overall risk is
16 , 17 unclear , it is likely to be elevated .
Although smoking is the largest single cause of lung cancer , people who have never smoked may also be diag-
|
for 2022 is estimated to be 43 cases |
access , especially for those who live |
cancer — squamous cell carcinoma |
carcinogens , and with increasing use |
nosed with the condition . PAGE 23 |