Lung cancer

Lung cancer, also known as lung carcinoma, is a malignant

Early lung cancer often has no symptoms and can only be detected by

Treatment for early stage lung cancer includes surgery to remove the tumor, sometimes followed by radiation therapy and chemotherapy to kill any remaining cancer cells. Later stage cancer is treated with radiation therapy and chemotherapy alongside drug treatments that target specific cancer subtypes. Even with treatment, only around 20% of people survive five years on from their diagnosis.^[4] Survival rates are higher in those diagnosed at an earlier stage, diagnosed at a younger age, and in women compared to men.

Most lung cancer cases are caused by

Lung cancer is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths.^[3] Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72.^[2] Incidence and outcomes vary widely across the world, depending on patterns of tobacco use. Prior to the advent of cigarette smoking in the 20th century, lung cancer was a rare disease. In the 1950s and 1960s, increasing evidence linked lung cancer and tobacco use, culminating in declarations by most large national health bodies discouraging tobacco use.

Early lung cancer often has no symptoms. When symptoms do arise they are often nonspecific respiratory problems – coughing, shortness of breath, or chest pain – that can differ from person to person.^[5] Those who experience coughing tend to report either a new cough, or an increase in the frequency or strength of a pre-existing cough.^[5] Around one in four cough up blood, ranging from small streaks in the sputum to large amounts.^[6][5] Around half of those diagnosed with lung cancer experience shortness of breath, while 25–50% experience a dull, persistent chest pain that remains in the same location over time.^[5] In addition to respiratory symptoms, some experience systemic symptoms including loss of appetite, weight loss, general weakness, fever, and night sweats.^[5][7]

Some less common symptoms suggest tumors in particular locations. Tumors in the

A person suspected of having lung cancer will have imaging tests done to evaluate the presence, extent, and location of tumors. First, many

Imaging is also used to assess the extent of cancer spread. Positron emission tomography (PET) scanning or combined PET-CT scanning is often used to locate metastases in the body. Since PET scanning is less sensitive in the brain, the National Comprehensive Cancer Network recommends magnetic resonance imaging (MRI) – or CT where MRI is unavailable – to scan the brain for metastases in those with NSCLC and large tumors, or tumors that have spread to the nearby lymph nodes.^[13] When imaging suggests the tumor has spread, the suspected metastasis is often biopsied to confirm that it is cancerous.^[11] Lung cancer most commonly metastasizes to the brain, bones, liver, and adrenal glands.^[14]

Lung cancer can often appear as a

At diagnosis, lung cancer is classified based on the type of cells the tumor is derived from; tumors derived from different cells progress and respond to treatment differently. There are two main types of lung cancer, categorized by the size and appearance of the malignant cells seen by a

Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is one of the factors affecting both the prognosis and the treatment of lung cancer.^[27]

SCLC is typically staged with a relatively simple system: limited stage or extensive stage. Around a third of people are diagnosed at the limited stage, meaning cancer is confined to one side of the chest, within the scope of a single

NSCLC – and sometimes SCLC – is typically staged with the American Joint Committee on Cancer's Tumor, Node, Metastasis (TNM) staging system.^[28] The size and extent of the tumor (T), spread to regional lymph nodes (N), and distant metastases (M) are scored individually, and combined to form stage groups.^[29]

Relatively small tumors are designated T1, which are subdivided by size: tumors ≤ 1

These T, N, and M scores are combined to designate a stage grouping for the cancer. Cancer limited to smaller tumors is designated stage I. Disease with larger tumors or spread to the nearest lymph nodes is stage II. Cancer with the largest tumors or extensive lymph node spread is stage III. Cancer that has metastasized is stage IV. Each stage is further subdivided based on the combination of T, N, and M scores.[31]

Some countries recommend that people who are at a high risk of developing lung cancer be screened at different intervals using low-dose CT lung scans. Screening programs may result in early detection of lung tumors in people who are not yet experiencing symptoms of lung cancer, ideally, early enough that the tumors can be successfully treated and result in decreased mortality.^[33] There is evidence that regular low-dose CT scans in people at high risk of developing lung cancer reduces total lung cancer deaths by as much as 20%.^[15] Despite evidence of benefit in these populations, potential harms of screening include the potential for a person to have a 'false positive' screening result that may lead to unnecessary testing, invasive procedures, and distress.^[34] Although rare, there is also a risk of radiation-induced cancer.^[34] The United States Preventive Services Task Force recommends yearly screening using low-dose CT in people between 55 and 80 who have a smoking history of at least 30 pack-years.^[35] The European Commission recommends that cancer screening programs across the European Union be extended to include low-dose CT lung scans for current or previous smokers.^[36] Similarly, The Canadian Task Force for Preventative Health recommends that people who are current or former smokers (smoking history of more than 30 pack years) and who are between the ages of 55–74 years be screened for lung cancer.^[37]

Treatment for lung cancer depends on the cancer's specific cell type, how far it has

Limited-stage SCLC is typically treated with a combination of chemotherapy and radiotherapy.

For stage I and stage II NSCLC the first line of treatment is often surgical removal of the affected lobe of the lung.

Treatment for those with stage III NSCLC depends on the nature of their disease. Those with more limited spread may undergo surgery to have the tumor and affected lymph nodes removed, followed by chemotherapy and potentially radiotherapy. Those with particularly large tumors (T4) and those for whom surgery is impractical are treated with combination chemotherapy and radiotherapy along with the immunotherapy durvalumab.^[44] Combined chemotherapy and radiation enhances survival compared to chemotherapy followed by radiation, though the combination therapy comes with harsher side effects.^[44]

Those with stage IV disease are treated with combinations of pain medication, radiotherapy, immunotherapy, and chemotherapy.

People whose NSCLC is not targetable by current molecular therapies instead can be treated with combination chemotherapy plus immune checkpoint inhibitors, which prevent cancer cells from inactivating immune T cells. The chemotherapeutic agent of choice depends on the NSCLC subtype: cisplatin plus gemcitabine for squamous cell carcinoma, cisplatin plus pemetrexed for non-squamous cell carcinoma.^[47] Immune checkpoint inhibitors are most effective against tumors that express the protein PD-L1, but are sometimes effective in those that do not.^[48] Treatment with pembrolizumab, atezolizumab, or combination nivolumab plus ipilimumab are all superior to chemotherapy alone against tumors expressing PD-L1.^[48] Those who relapse on the above are treated with second-line chemotherapeutics docetaxel and ramucirumab.^[49]

Integrating palliative care (medical care focused on improving symptoms and lessening discomfort) into lung cancer treatment from the time of diagnosis improves the survival time and quality of life of those with lung cancer.^[50] Particularly common symptoms of lung cancer are shortness of breath and pain. Supplemental oxygen, improved airflow, re-orienting an affected person in bed, and low-dose morphine can all improve shortness of breath.^[51] In around 20 to 30% of those with lung cancer – particularly those with late-stage disease – growth of the tumor can narrow or block the airway, causing coughing and difficulty breathing.^[52] Obstructing tumors can be surgically removed where possible, though typically those with airway obstruction are not well enough for surgery. In such cases the American College of Chest Physicians recommends opening the airway by inserting a stent, attempting to shrink the tumor with localized radiation (brachytherapy), or physically removing the blocking tissue by bronchoscopy, sometimes aided by thermal or laser ablation.^[53] Other causes of lung cancer-associated shortness of breath can be treated directly, such as antibiotics for a lung infection, diuretics for pulmonary edema, benzodiazepines for anxiety, and steroids for airway obstruction.^[51]

Up to 92% of those with lung cancer report pain, either from tissue damage at the tumor site(s) or nerve damage.

Around 19% of people diagnosed with lung cancer survive five years from diagnosis, though prognosis varies based on the stage of the disease at diagnosis and the type of lung cancer.^[4] Prognosis is better for people with lung cancer diagnosed at an earlier stage; those diagnosed at the earliest TNM stage, IA1 (small tumor, no spread), have a two-year survival of 97% and five-year survival of 92%.^[57] Those diagnosed at the most-advanced stage, IVB, have a two-year survival of 10% and a five-year survival of 0%.^[57] Five-year survival is higher in women (22%) than men (16%).^[4] Women tend to be diagnosed with less-advanced disease, and have better outcomes than men diagnosed at the same stage.^[58] Average five-year survival also varies across the world, with particularly high five-year survival in Japan (33%), and five-year survival above 20% in 12 other countries: Mauritius, Canada, the US, China, South Korea, Taiwan, Israel, Latvia, Iceland, Sweden, Austria, and Switzerland.^[59]

SCLC is particularly aggressive. 10–15% of people survive five years after a SCLC diagnosis.^[39] As with other types of lung cancer, the extent of disease at diagnosis also influences prognosis. The average person diagnosed with limited-stage SCLC survives 12–20 months from diagnosis; with extensive-stage SCLC around 12 months.^[39] While SCLC often responds initially to treatment, most people eventually relapse with chemotherapy-resistant cancer, surviving an average 3–4 months from the time of relapse.^[39] Those with limited stage SCLC that go into complete remission after chemotherapy and radiotherapy have a 50% chance of brain metastases developing within the next two years – a chance reduced by prophylactic cranial irradiation.^[40]

Several other personal and disease factors are associated with improved outcomes. Those diagnosed at a younger age tend to have better outcomes. Those who smoke or experience weight loss as a symptom tend to have worse outcomes. Tumor mutations in KRAS are associated with reduced survival.^[58]

The uncertainty of lung cancer prognosis often causes stress, and makes future planning difficult, for those with lung cancer and their families.^[60] Those whose cancer goes into remission often experience fear of their cancer returning or progressing, associated with poor quality of life, negative mood, and functional impairment. This fear is exacerbated by frequent or prolonged surveillance imaging, and other reminders of cancer risks.^[60]

Lung cancer is caused by

Tobacco smoking is by far the major contributor to lung cancer, causing 80% to 90% of cases.^[64] Lung cancer risk increases with quantity of cigarettes consumed.^[65] Tobacco smoking's carcinogenic effect is due to various chemicals in tobacco smoke that cause DNA mutations, increasing the chance of cells becoming cancerous.^[66] The International Agency for Research on Cancer identifies at least 50 chemicals in tobacco smoke as carcinogenic, and the most potent is tobacco-specific nitrosamines.^[65] Exposure to these chemicals causes several kinds of DNA damage: DNA adducts, oxidative stress, and breaks in the DNA strands.^[67] Being around tobacco smoke – called passive smoking – can also cause lung cancer. Living with a tobacco smoker increases one's risk of developing lung cancer by 24%. An estimated 17% of lung cancer cases in those who do not smoke are caused by high levels of environmental tobacco smoke.^[68]

Vaping may be a risk factor for lung cancer, but less than that of cigarettes, and further research as of 2021 is necessary due to the length of time it can take for lung cancer to develop following an exposure to carcinogens.^[69]

The smoking of non-tobacco products is not known to be associated with lung cancer development. Marijuana smoking does not seem to independently cause lung cancer – despite the relatively high levels of tar and known carcinogens in marijuana smoke. The relationship between smoking cocaine and developing lung cancer has not been studied as of 2020.^[70]

Exposure to a variety of other toxic chemicals – typically encountered in certain occupations – is associated with an increased risk of lung cancer.

Those who smoke can reduce their lung cancer risk by quitting smoking – the risk reduction is greater the longer a person goes without smoking.[83] Self-help programs tend to have little influence on success of smoking cessation, whereas combined counseling and pharmacotherapy improve cessation rates.^[83] The US FDA has approved antidepressant therapies and the nicotine replacement varenicline as first-line therapies to aid in smoking cessation. Clonidine and nortriptyline are recommended second-line therapies.^[83] The majority of those diagnosed with lung cancer attempt to quit smoking; around half succeed.^[84] Even after lung cancer diagnosis, smoking cessation improves treatment outcomes, reducing cancer treatment toxicity and failure rates, and lengthening survival time.^[85]

No smoking sign at a train station in Colorado

Graphic cigarette packaging in Belgium labelled "open wound following lung surgery"

At a societal level, smoking cessation can be promoted by tobacco control policies that make tobacco products more difficult to obtain or use. Many such policies are mandated or recommended by the WHO Framework Convention on Tobacco Control, ratified by 182 countries, representing over 90% of the world's population.^[86] The WHO groups these policies into six intervention categories, each of which has been shown to be effective in reducing the cost of tobacco-induced disease burden on a population:

1. increasing the price of tobacco by raising taxes;
2. banning tobacco use in public places to reduce exposure;
3. banning tobacco advertisements;
4. publicizing the dangers of tobacco products;
5. instituting help programs for those attempting to quit smoking; and
6. monitoring population-level tobacco use and the effectiveness of tobacco control policies.^[87]

Policies implementing each intervention are associated with decreases in tobacco smoking prevalence. The more policies implemented, the greater the reduction.^[88] Reducing access to tobacco for adolescents is particularly effective at decreasing uptake of habitual smoking, and adolescent demand for tobacco products is particularly sensitive to increases in cost.^[89]

Several foods and dietary supplements have been associated with lung cancer risk. High consumption of some animal products –

Along with diet, body weight and exercise habits are also associated with lung cancer risk. Being overweight is associated with a lower risk of developing lung cancer, possibly due to the tendency of those who smoke cigarettes to have a lower body weight.^[92] However, being underweight is also associated with a reduced lung cancer risk.^[92] Some studies have shown those who exercise regularly or have better cardiovascular fitness to have a lower risk of developing lung cancer.^[92]

Worldwide, lung cancer is the most diagnosed type of cancer, and the leading cause of cancer death.^[94][95] In 2020, 2.2 million new cases were diagnosed, and 1.8 million people died from lung cancer, representing 18% of all cancer deaths.^[3] Lung cancer deaths are expected to rise globally to nearly 3 million annual deaths by 2035, due to high rates of tobacco use and aging populations.^[95] Lung cancer is rare among those younger than 40; after that, cancer rates increase with age, stabilizing around age 80.^[1] The median age of a person diagnosed with lung cancer is 70; the median age of death is 72.^[2]

Lung cancer incidence varies by geography and sex, with the highest rates in Micronesia, Polynesia, Europe, Asia, and North America; and lowest rates in Africa and Central America.^[96] Globally, around 8% of men and 6% of women develop lung cancer in their lifetimes.^[1] The ratio of lung cancer cases in men to women varies considerably by geography, from as high as nearly 12:1 in Belarus, to 1:1 in Brazil, likely due to differences in smoking patterns.^[97]

Lung cancer risk is influenced by environmental exposure, namely cigarette smoking, as well as occupational risks in mining, shipbuilding, petroleum refining, and occupations that involve asbestos exposure.

Lung cancer was uncommon before the advent of cigarette smoking. Surgeon Alton Ochsner recalled that as a Washington University medical student in 1919, his entire medical school class was summoned to witness an autopsy of a man who had died from lung cancer, and told they may never see such a case again.^[99][100] In Isaac Adler's 1912 Primary Malignant Growths of the Lungs and Bronchi, he called lung cancer "among the rarest forms of disease";^[101] Adler tabulated the 374 cases of lung cancer that had been published to that time, concluding the disease was increasing in incidence.^[102] By the 1920s, several theories had been put forward linking the increase in lung cancer to various chemical exposures that had increased including tobacco smoke, asphalt dust, industrial air pollution, and poisonous gasses from World War I.^[102]

Over the following decades, growing scientific evidence linked lung cancer to cigarette consumption. Through the 1940s and early 1950s, several

A 1953 study showing that tar from cigarette smoke could cause tumors in mice attracted attention in the popular press, with features in

As evidence linking tobacco use with lung cancer mounted, various health bodies announced official positions linking the two. In 1962, the United Kingdom's Royal College of Physicians officially concluded that cigarette smoking causes lung cancer, prompting the United States Surgeon General to empanel (enroll or enlist) an advisory committee, which deliberated in secret over nine sessions between November 1962 and December 1963.^[107] The committee's report, published in January 1964, firmly concluded that cigarette smoking "far outweighs all other factors" in causing lung cancer.^[108] The report received substantial coverage in the popular press, and is widely seen as a turning point for public recognition that tobacco smoking causes lung cancer.^[107][109]

The connection with radon gas was first recognized among miners in Germany's Ore Mountains. As early as 1500, miners were noted to develop a deadly disease called "mountain sickness" ("Bergkrankheit"), identified as lung cancer by the late 19th century.^[110][111] By 1938, up to 80% of miners in affected regions died from the disease.^[110] In the 1950s radon and its breakdown products became established as causes of lung cancer in miners. Based largely on studies of miners, the International Agency for Research on Cancer classified radon as "carcinogenic to humans" in 1988.^[111] In 1956, a study revealed radon in Swedish residences. Over the following decades, high radon concentrations were found in residences across the world; by the 1980s many countries had established national radon programs to catalog and mitigate residential radon.^[112]

The first successful

Evarts Graham at Barnes Hospital in St. Louis, Missouri.^[113] Over the following decades, surgical development focused on sparing as much healthy lung tissue as possible, with the lobectomy surpassing the pneumectomy in frequency by the 1960s, and the wedge resection appearing in the early 1970s.^[114][115] This trend continued with the development of video-assisted thoracoscopic surgery in the 1980s, now widely performed for many lung cancer surgeries.^[116]

Research

While lung cancer is the deadliest type of cancer, it receives the third-most funding from the US

brain cancers and breast cancer.^[117] Despite high levels of gross research funding, lung cancer funding per death lags behind many other cancers, with around $3,200 spent on lung cancer research in 2022 per US death, considerably lower than that for brain cancer ($22,000 per death), breast cancer ($14,000 per death), and cancer as a whole ($11,000 per death).^[118] A similar trend holds for private nonprofit organizations. Annual revenues of lung cancer-focused nonprofits rank fifth among cancer types, but lung cancer nonprofits have lower revenue than would be expected for the number of lung cancer cases, deaths, and potential years of life lost.^[119]

Despite this, many investigational lung cancer treatments are undergoing clinical trials – with nearly 2,250 active clinical trials registered as of 2021.^[120] Of these, a large plurality are testing radiotherapy regimens (26% of trials) and surgical techniques (22%). Many others are testing targeted anticancer drugs, with targets including EGFR (17% of trials), microtubules (12%), VEGF (12%), immune pathways (10%), mTOR (1%), and histone deacetylases (<1%).^[121]

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  ISBN 978-92-76-45603-2
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• Horn L, Iams WT (2022). "78: Neoplasms of the Lung". In Loscalzo J, Fauci A, Kasper D, et al. (eds.).
  ISBN 978-1264268504
  .
• Morgensztern D, Boffa D, Chen A, Dhanasopon A, Goldberg SB, Decker RH, Devarakonda S, Ko JP, Solis Soto LM, Waqar SN, Wistuba II, Herbst RS (April 2023). "80: Cancer of the Lung". In Bast RC, Byrd JC, Croce CM, et al. (eds.). Holland-Frei Cancer Medicine (10th ed.). Wiley.
  ISBN 978-1-119-75068-0
  .
• Salahuddin M, Ost DE (2023). "110: Approach to the Patient with Pulmonary Nodules". In Grippi MA, Antin-Ozerkis DE, Dela Cruz CS, et al. (eds.). Fishman's Pulmonary Diseases and Disorders (6th ed.). McGraw Hill.
  ISBN 978-1260473988
  .

Journal articles

• Alexander M, Kim SY, Cheng H (December 2020). "Update 2020: Management of Non-Small Cell Lung Cancer". Lung. 198 (6): 897–907.
  PMID 33175991
  .
• Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. (March 2018). "Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries". Lancet. 391 (10125): 1023–1075.
  PMID 29395269
  .
• Aragon KN (June 2020). "Palliative Care in Lung Cancer". Clin Chest Med. 41 (2): 281–293.
  S2CID 218633948
  .
• Arnott D, Lindorff K, Goddard A (August 2022). "Tobacco control: the FCTC provides the route to the finish line". Lancet. 400 (10350): 427.
  S2CID 250960604
  .
• Bade BC, Dela Cruz CS (March 2020). "Lung Cancer 2020: Epidemiology, Etiology, and Prevention". Clin Chest Med. 41 (1): 1–24.
  S2CID 211015015
  .
• Batra H, Pawar S, Bahl D (February 2021). "Current clinical trials and patent update on lung cancer: a retrospective review". Lung Cancer Management. 10 (5): LMT45.
  PMID 34084211
  .
• Blum A (July 1999). "Alton ochsner, MD, 1896–1981 anti-smoking pioneer". Ochsner J. 1 (3): 102–105.
  PMID 21845126
  .
• Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, Finn SP (March 2021). "Vaping and lung cancer – A review of current data and recommendations". Lung Cancer. 153: 11–20.
  S2CID 231586192
  .
• Brandt AM (January 2012). "Inventing conflicts of interest: a history of tobacco industry tactics". Am J Public Health. 102 (1): 63–71.
  PMID 22095331
  .
• Canadian Task Force on Preventive Health Care (April 2016). "Recommendations on screening for lung cancer". CMAJ. 188 (6): 425–432.
  PMID 26952527
  .
• Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. (January 2016). "The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (8th) ed. of the TNM Classification for Lung Cancer". J Thorac Oncol. 11 (1): 39–51.
  S2CID 5368645
  .
• Hall W (December 2022). "The 1964 US Surgeon General's report on smoking and health". Addiction. 117 (12): 3170–3175.
  S2CID 250642397
  .
• Horn L, Johnson DH (July 2008). "Evarts A. Graham and the first pneumonectomy for lung cancer". Journal of Clinical Oncology. 26 (19): 3268–3275.
  PMID 18591561. Archived from the original
  on 17 March 2020. Retrieved 20 March 2009.
• Jassem J (May 2019). "Tobacco smoking after diagnosis of cancer: clinical aspects". Translational Lung Cancer Research. 8 (Suppl 1): S50 – S58.
  PMID 31211105
  .
• Jonas DE, Reuland DS, Reddy SM, Nagle M, Clark SD, Weber RP, Enyioha C, Malo TL, Brenner AT, Armstrong C, Coker-Schwimmer M, Middleton JC, Voisin C, Harris RP (March 2021). "Screening for Lung Cancer With Low-Dose Computed Tomography: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force". JAMA. 325 (10): 971–987.
  S2CID 232159404
  .
• Jones KD (December 2013). "Whence lepidic?: the history of a Canadian neologism". Arch Pathol Lab Med. 137 (12): 1822–1824.
  PMID 23937575
  .
• Kamath SD, Kircher SM, Benson AB (July 2019). "Comparison of Cancer Burden and Nonprofit Organization Funding Reveals Disparities in Funding Across Cancer Types". J Natl Compr Canc Netw. 17 (7): 849–854.
  S2CID 197666475
  .
• Lim RB (October 2016). "End-of-life care in patients with advanced lung cancer". Ther Adv Respir Dis. 10 (5): 455–467.
  PMID 27585597
  .
• Lim W, Ridge CA, Nicholson AG, Mirsadraee S (August 2018). "The 8th lung cancer TNM classification and clinical staging system: review of the changes and clinical implications". Quantitative Imaging in Medicine and Surgery. 8 (7): 709–718.
  PMID 30211037
  .
• Mc Laughlin J (November 2012). "An historical overview of radon and its progeny: applications and health effects". Radiat Prot Dosimetry. 152 (1–3): 2–8.
  PMID 22914338
  .
• Nasim F, Sabath BF, Eapen GA (May 2019). "Lung Cancer". Med Clin North Am. 103 (3): 463–473.
  S2CID 102349766
  .
• Obeng C, Folch E, Fernando Santacruz J (December 2018). "Management of malignant airway obstruction". AME Medical Journal. 3: 115.
  S2CID 80791599
  .
• Parascandola M (March 2020). "The other Surgeon General's report: history of the U.S. public health response to air pollution, cigarette smoking, and lung cancer". Annals of Cancer Epidemiology. 4: 3.
  S2CID 216205576
  .
• Peruga A, López MJ, Martinez C, Fernández E (March 2021). "Tobacco control policies in the 21st century: achievements and open challenges". Mol Oncol. 15 (3): 744–752.
  PMID 33533185
  .
• Proctor RN (March 2012). "The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll". Tob Control. 21 (2): 87–91.
  S2CID 2734836
  .
• Rudin CM, Brambilla E, Faivre-Finn C, Sage J (January 2021). "Small-cell lung cancer". Nat Rev Dis Primers. 7 (1): 3.
  PMID 33446664
  .
• Schabath MB, Cote ML (October 2019). "Cancer Progress and Priorities: Lung Cancer". Cancer Epidemiol Biomarkers Prev. 28 (10): 1563–1579.
  PMID 31575553
  .
• Spencer K, Parrish R, Barton R, Henry A (March 2018). "Palliative radiotherapy". BMJ. 360: k821.
  PMID 29572337
  .
• Spiro SG, Silvestri GA (September 2005). "One hundred years of lung cancer". American Journal of Respiratory and Critical Care Medicine. 172 (5): 523–529.
  PMID 15961694
  .
• Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (May 2021). "Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries". CA: A Cancer Journal for Clinicians. 71 (3): 209–249.
  PMID 33538338
  .
• Temel JS, Petrillo LA, Greer JA (February 2022). "Patient-Centered Palliative Care for Patients With Advanced Lung Cancer". J Clin Oncol. 40 (6): 626–634.
  S2CID 245772225
  .
• Thai AA, Solomon BJ, Sequist LV, Gainor JF, Heist RS (August 2021). "Lung cancer". Lancet. 398 (10299): 535–554.
  S2CID 236034814
  .
• Walcott-Sapp S, Sukumar M (8 December 2016). "The history of pulmonary lobectomy: Two phases of innovation". CTSNet. Retrieved 28 April 2023.
• Witschi H (November 2001). "A short history of lung cancer". Toxicological Sciences. 64 (1): 4–6.
  PMID 11606795
  .

External links

Wikimedia Commons has media related to Cancers of bronchus and lung.

Wikiquote has quotations related to Lung cancer.