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Vol. 45. Issue 7.
Pages 341-348 (July 2009)
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Vol. 45. Issue 7.
Pages 341-348 (July 2009)
Review Article
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Lung Cancer in Spain. Current Epidemiology, Survival, and Treatment
El cáncer de pulmón en España. Epidemiología, supervivencia y tratamientos actuales
Visits
9691
Julio Sánchez de Cos Escuín
CibeRes, Sección de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain
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Abstract

In 2005, 19 115 people died of lung cancer in Spain. In spite of the increase in absolute mortality rates since 1950, the adjusted rate for men has declined. The incidence among women is lower in Spain than in other countries but it has increased (with a ratio of 1 woman for every 8.5 men). More than 50% of the patients are over 70 years of age. While the proportion of adenocarcinomas relative to other histological types has increased worldwide, squamous cell carcinoma still predominates in Spain (ranging from 24%- 50.5%). The number of patients treated by surgical resection has not increased (14.8% in Spain in 2003). Operative mortality is 6.8%. Between 25% and 50% of patients receive only palliative medication. Absolute overall survival in patients with lung cancer is under 10% in many countries. The 5-year survival rate among patients treated surgically has increased slightly, with stage IA rates ranging from 58.3% to 68.5% and stage IIIA from 28.3% to 35.8%..

Keywords:
Lung cancer
Epidemiology
Survival
Treatment
Resumen

En 2005 fallecieron 19.115 personas por cáncer de pulmón en España. Pese al aumento de las cifras absolutas de mortalidad desde 1950, las tasas ajustadas en varones han disminuido. La incidencia en mujeres, inferior a la de otros países, ha aumentado (1 por cada 8,5 varones). Más del 50% de los pacientes tienen más de 70 años. La proporción de adenocarcinomas ha aumentado en el mundo, aunque en España la estirpe epidermoide es predominante (24-50,5%). Las resecciones quirúrgicas (un 14,8% en España, en 2003) no han aumentado. La mortalidad operatoria es del 6,8%. Un 25-50% de los pacientes recibe sólo medicación paliativa. La supervivencia absoluta global del cáncer de pulmón es menor del 10% en muchos países. Entre pacientes resecados, la supervivencia a los 5 años (estadio IA: 58,3-68,5%; estadio IIIA: 28,3-35,8%) ha aumentado ligeramente.

Palabras clave:
Cáncer de pulmón
Epidemiología
Supervivencia
Tratamiento
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References
[1.]
Instituto Nacional de Estadística. Defunciones según la causa de muerte en España. 2005. Madrid, 2008. Available from: http://www.ine.es
[2.]
E. Fernández, J.R. González, J.M. Borrás, V. Moreno, V. Sánchez, M. Peris.
Recent decline in cancer mortality in Catalonia (Spain). A joinpoint regression analysis.
Eur J Cancer, 37 (2001), pp. 2222-2228
[3.]
A. Cayuela, S. Rodríguez-Domínguez, R. Otero.
Evolución de la mortalidad por cáncer de pulmón en las provincias de Andalucía (1975-2002).
Arch Bronconeumol, 42 (2006), pp. 633-637
[4.]
C. Montero, M. Rosales, I. Otero, M. Blanco, G. Rodríguez, S. Peterga, et al.
Cáncer de pulmón en el Área Sanitaria de A Coruña: incidencia, abordaje clínico y supervivencia.
Arch Bronconeumol, 39 (2003), pp. 209-216
[5.]
L. Miravet, A. Paradís, S. Peláez, M. Arnal, F. Cabadés.
Evolución del carcinoma broncopulmonar en el norte de la provincia de Castellón 1993-2002.
Arch Bronconeumol, 40 (2004), pp. 553-557
[6.]
M.A. Alonso-Fernández, M. García-Clemente, C. Escudero-Bueno.
Características del carcinoma broncopulmonar en una región del norte de España.
Arch Bronconeumol, 41 (2005), pp. 478-483
[7.]
J.R. Hernández Hernández, J.A. Tapias del Pozo, P. Moreno Canelo, A. Rodríguez Puebla, J.C. Sánchez Marcos.
Incidencia del cáncer de pulmón en la provincia de Ávila. Año 2002 y tendencias en una década.
Arch Bronconeumol, 40 (2004), pp. 304-310
[8.]
J. Abal, M.A. Blanco, M. Tumbeiro, J.M. García, P. Prieto, M. Riu.
Estudio epidemiológico clínico del cáncer de pulmón en el año 2003.
Arch Bronconeumol, 42 (2006),
[9.]
J. Sánchez de Cos Escuín, L. Miravet, J. Abal, A. Núñez, J. Hernández, A.M. Castañar, et al.
Estudio multicéntrico epidemiológico-clínico de cáncer de pulmón en España (estudio EpicliCP-2003).
Arch Bronconeumol, 42 (2006), pp. 446-452
[10.]
National Cancer Institute. SEER. Cancer Statistic Review 1975-2001. Available from: http://www.statecancerprofiles.cancer.gov
[11.]
J. Subramanian, R. Govindan.
Lung cancer in never smokers. A review.
J Clin Oncol, 25 (2007), pp. 561-570
[12.]
H.A. Wakelee, E.T. Chang, S.L. Gómez, T.H. Keegan, D. Feskanich, C.A. Clarke, et al.
Lung cancer incidence in never smokers.
J Clin Oncol, 25 (2007), pp. 561-570
[13.]
A.F. Gazdar, M.J. Thun.
Lung cancer, smoke exposure, and sex.
J Clin Oncol, 25 (2007), pp. 469-471
[14.]
L. Thomas, A. Doyle, J. Edelman.
Lung cancer in women. Emerging differences in epidemiology, biology and therapy.
Chest, 128 (2005), pp. 370-381
[15.]
ELCAP investigators.
Women's susceptibility to tobacco carcinogens and survival after diagnosis of lung cancer.
JAMA, 296 (2006), pp. 180-184
[16.]
J.D. Patel, P.B. Bach, M.G. Kris.
Lung cancer in US women. A contemporary epidemic.
JAMA, 291 (2004), pp. 1763-1768
[17.]
C.I. Henschke, O.S. Miettinen.
Women's susceptibility to tobacco carcinogens.
Lung cancer, 43 (2004), pp. 1-5
[18.]
H.A. Risch, A.B. Miller.
Are women more susceptible to lung cancer?.
J Natl Cancer Inst, 96 (2004), pp. 1560-1561
[19.]
W.J. Blot, J.K. McLaughlin.
Are women more susceptible to lung cancer?.
J Natl Cancer Inst, 96 (2004), pp. 812-813
[20.]
J. Olak, Y. Colson.
Gender differences in lung cancer: have we really come a long way, baby?.
J Thorac Cardiovasc Surg, 128 (2004), pp. 346-351
[21.]
C. Bain, D. Feskanich, F.E. Speizer, M. Thun, E. Hertzmark, B.A. Rosner, et al.
Lung cancer rates in men and women with comparable histories of smoking.
J Natl Cancer Inst, 96 (2004), pp. 826-834
[22.]
H.K. Weir, M.J. Thun, B.F. Hankey, L.A.G. Ries, H.L. Howe, P.A. Wingo, et al.
Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control.
J Natl Cancer Inst, 95 (2003), pp. 1276-1299
[23.]
M.L.G. Janssen-Heijnen, S. Smulders, V.E.P.P. Lemmens, F.W.J.M. Smeenk, H.J.A.A. van Geffen, J.W.W. Coebergh.
Effect of comorbidity on the treatment and prognosis of elderly patients with non-small cell lung cancer.
Thorax, 59 (2004), pp. 602-607
[24.]
C.M. Free, M. Ellis, L. Beggs, D. Beggs, S.A. Morgan, D.R. Baldwin.
Lung cancer outcomes at a UK cancer unit between 1998-2001.
Lung Cancer, 57 (2007), pp. 222-228
[25.]
A. Gregor, C.S. Thomson, D.H. Brewster, P.l. Stroner, J. Davidson, R.J. Fergusson.
Management and survival of patients with lung cancer in Scotland diagnosed in 1995: results of a national population based study.
Thorax, 56 (2001), pp. 212-217
[26.]
R. Mäkitaro, P. Pääkko, E. Huhti, R. Bloigu, V.L. Kinnula.
An epidemiological study of lung cancer: history and histological types in a general population in northern Finland.
Eur Respir J, 13 (1999), pp. 436-440
[27.]
H. Koyi, G. Hillerdal, E. Brandén.
A prospective study of a total material of lung cancer from a county in Sweden 1997-1999: gender, symptoms, type, stage, and smoking habits.
Lung Cancer, 36 (2002), pp. 9-14
[28.]
A. Imperatori, R.N. Harrison, D.N. Leitch, F. Rovera, G. Lepore, G. Dionigi, et al.
Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival.
Thorax, 61 (2006), pp. 232-239
[29.]
Grupo de estudio del carcinoma broncopulmonar de la SOCALPAR.
Incidencia del carcinoma broncopulmonar en Castilla-León durante el año 1997. Estudio multicéntrico de la Sociedad Castellano-Leonesa de Patología Respiratoria (SOCALPAR).
Arch Bronconeumol, 36 (2000), pp. 313-318
[30.]
L. Miravet, S. Peláez, A. Paradis, M. Amal, F. Cabades.
Estudio epidemiológico del cáncer pulmonar en el norte de la provincia de Castellón.
Arch Bronconeumol, 37 (2001), pp. 298-301
[31.]
J. Sánchez de Cos Escuín, C. Disdier Vicente, J. Corral Peñafiel, J.A. Riesco Miranda, M.A. Sojo González, J.F. Masa Jiménez.
Supervivencia global a largo plazo en el cáncer de pulmón. Análisis de una serie de 610 pacientes no seleccionados.
Arch Bronconeumol, 40 (2004), pp. 268-274
[32.]
G. Estrada Trigueros, L. Comeche, A. López Encuentra, J. Montoso Zulueta, F. González Garrido, F. Colina.
Carcinoma broncogénico 2000-2001.
Características y supervivencia global Arch Bronconeumol, 43 (2007), pp. 594-598
[33.]
J. Sánchez de Cos Escuín, L. Miravet, J. Abal, A. Núñez, F.J. Muñoz, L. García, et al.
Lung cancer survival in Spain: a prospective, multiregional study.
Lung Cancer, 59 (2008), pp. 246-254
[34.]
A.J. Alberg, J.G. Ford, J.M. Samet.
Epidemiology of lung cancer. ACCP Evidence-Based Clinical Practice Guidelines (2nd edition).
Chest, 132 (2007), pp. 29S-55S
[35.]
C.K. Toh, F. Gao, W.T. Lim, S.S. Leong, K.W. Fong, S.P. Yap, et al.
Never-smokers with lung cancer: epidemiologic evidence of a distinct disease entity.
J Clin Oncol, 24 (2006), pp. 2245-2251
[36.]
C.K. Toh, F. Gao, W.T. Lim, S.S. Leong, K.W. Fong, S.P. Yap, et al.
Differences between small-cell lung cancer and non-small cell lung cancer among tobacco smokers.
Lung Cancer, 56 (2007), pp. 161-166
[37.]
R. Govindan, N. Page, D. Morgensztern, W. Read, R. Tierney, A. Vlahiotis, et al.
Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database.
J Clin Oncol, 24 (2006), pp. 4539-4544
[38.]
D.S. Ettinger.
Changing FACE of small-cell lung cancer: real and artifact.
J Clin Oncol, 24 (2006), pp. 4526-4527
[39.]
M.L.G. Janssen-Heijnen, J.W.W. Coebergh.
The changing epidemiology of lung cancer in Europe.
Lung Cancer, 41 (2003), pp. 245-258
[40.]
C.G. Chute, E.R. Greenberg, J. Baron, R. Korson, J. Baker, J. Yates, et al.
Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont.
Cancer, 56 (1985), pp. 2107-2112
[41.]
J. Sánchez de Cos, J. Redondo, M.A. Sever.
Carcinoma broncopulmonar. Estudio epidemiológico-clínico de 157 casos.
Aten Primaria, 6 (1989), pp. 304-311
[42.]
J. Sánchez de Cos Escuín, J.A. Riesco Miranda, J. Antón Martínez, P. Díez Santamaría, L. Márquez Pérez, J.F. Medina Gallardo, et al.
Incidencia de carcinoma broncopulmonar en Extremadura durante el año 1998.
Arch Bronconeumol, 36 (2000), pp. 381-384
[43.]
R.L. Manser, L.B. Irving, G. Byrnes, M.J. Abramson, C.A. Stone, D.A. Campbell.
Screening for lung cancer: a systematic review and meta-analysis of controlled trials.
Thorax, 58 (2003), pp. 784-789
[44.]
ELCAP investigators.
Survival of patients with stage I lung cancer detected on CT screening.
N Engl J Med, 355 (2006), pp. 1763-1771
[45.]
C. Black, R. De Verteuil, S.H. Walker, J. Ayres, A. Boland, A. Bagust, et al.
Population screening for lung cancer using computed tomography, is there evidence of clinical effectiveness? A systematic review of the literature.
Thorax, 62 (2007), pp. 131-138
[46.]
U. Pastorino, M. Bellomi, C. Landoni, E. De Fiori, P. Arnaldi, M. Picchio, et al.
Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results.
[47.]
R. Mac Redmond, P.M. Logan, M. Lee, D. Kenny, C. Foley, R.V. Costello.
Screening for lung cancer using low-dose CT scanning.
Thorax, 59 (2004), pp. 237-241
[48.]
L. Callol, F. Roig, A. Cuevas, J.I. De Granda, F. Villegas, J. Jareño, et al.
Low-dose CT: a useful and accessible tool for early diagnosis of lung cancer in selected populations.
Lung Cancer, 56 (2007), pp. 217-221
[49.]
T. Vierikko, R. Järvenpää, T. Autti, P. Oksa, M. Huuskonen, S. Kaleva, et al.
Chest CT screening of asbestos-exposed workers: lung lesions and incidental findings.
Eur Respir J, 29 (2007), pp. 78-84
[50.]
P.B. Bach, J.R. Jett, U. Pastorino, M.S. Tockman, S. Swensen, C. Begg.
Computed tomography screening and lung cancer outcomes.
JAMA, 297 (2007), pp. 953-961
[51.]
G.A. Silvestri.
Screening for lung cancer in a high-risk group: but I still haven’t found what I’m looking for.
Eur Respir J, 29 (2007), pp. 6-7
[52.]
A. Phillips.
Resection rates in lung cancer.
Thorax, 54 (1999), pp. 374
[53.]
W.A. Fry, J.L. Phillips, H.R. Menck.
Ten-year survey of lung cancer treatment and survival in hospitals in the United States.
Cancer, 86 (1999), pp. 1867-1876
[54.]
A. Verdecchia, S. Francisci, H. Brenner, G. Gatta, A. Micheli, L. Mangone, et al.
Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data.
Lancet Oncol, 8 (2007), pp. 784-796
[55.]
F. Berrino, R. DeAngelis, M. Sant, S. Rosso, M.B. Lasota, J.W. Coebergh, et al.
Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study.
Lancet Oncol, 8 (2007), pp. 773-783
[56.]
L. Debevec, A. Debeljak.
Outcomes of unselected routinely treated lung cancer patients.
Lung cancer, 59 (2008), pp. 140-141
[57.]
R.A.M. Damhuis, P.R. Schütte.
Resection rates and postoperative mortality in 7899 patients with lung cancer.
Eur Respir J, 9 (1996), pp. 7-10
[58.]
R. Mäkitaro, P. Pääkko, E. Huhti, R. Bloigu, V.L. Kinnula.
Prospective population-based study on the survival of patients with lung cancer.
Eur Respir J, 19 (2002), pp. 1087-1092
[59.]
K. Moghissi, C.K. Connolly.
Resection rates in lung cancer patients.
Eur Respir J, 9 (1996), pp. 5-6
[60.]
C. Laroche, F. Wells, R. Coulden, S. Stewart, M. Goddard, E. Lowry, et al.
Improving surgical resection rate in lung cancer.
Thorax, 53 (1998), pp. 445-449
[61.]
M.R. Partirdge.
Thoracic surgery in a crisis.
BMJ, 324 (2002), pp. 376-377
[62.]
J. Sánchez de Cos, L. Miravet, A. Núñez, J. Abal, J. Hernández, C. Montero, et al.
Lung cancer in Spain Last epidemiological trends concerning age, gender, smoking prevalence and histological types.
Proceedings of the 11th World Conference on Lung Cancer; July 3-6,
[63.]
J.L. Duque, F. Gandía, J.M. Matilla.
Morbimortalidad postoperatoria en la cirugía del cáncer de pulmón.
Cáncer de pulmón, pp. 125-141
[64.]
A.G. Little, V.W. Rusch, J.A. Bonner.
Patterns of surgical care of lung cancer patients.
Ann Thorac Surg, 80 (2005), pp. 2051-2056
[65.]
T.-E. Strand, H. Rostad, R.A.M. Damhuis, J. Norstein.
Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude.
Thorax, 62 (2007), pp. 991-997
[66.]
J.L. Duque, R. Rami-Porta, A. Almaraz, M. Castanedo, J. Freixinet, A. Fernández de Rota, et al.
Parámetros de riesgo en la cirugía del carcinoma broncogénico.
Arch Bronconeumol, 43 (2007), pp. 143-149
[67.]
T. Sioris, E. Sihvo, R. Sankila, J. Salo.
Effect of surgical volume and hospital type on outcome in non-small cell lung cancer surgery: a Finnish population-based study.
Lung Cancer, 59 (2008), pp. 119-125
[68.]
F.A. Shepherd, J. Rodrigues Pereira, T. Ciuleanu, E.H. Tan, V. Hirsh, S. Thongprasert, et al.
Erlotinib in previously treated non-small-cell lung cancer.
N Engl J Med, 353 (2005), pp. 123-132
[69.]
A. Sandler, R. Gray, M.C. Perry, J. Brahmer, J. Schiller, A. Dowlati, et al.
Paclitaxelcarboplatin alone or with bevacizumab for non-small cell lung cancer.
N Engl J Med, 355 (2006), pp. 2542-2550
[70.]
M. Ranson, N. Davidson, M. Nicolson, S. Falk, J. Carmichael, P. López, et al.
Randomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non small-cell lung cancer.
J Natl Cancer Inst, 92 (2000), pp. 1074-1080
[71.]
K. Roszkowski, A. Pluzanska, Krakowski.
A multicenter, randomized phase III study of docetaxel plus best supportive care versus best supportive care in chemotherapy naïve patients with metastatic or non-resectable localized non-small cell lung cancer (NSCLC).
Lung Cancer, 27 (2000), pp. 145-157
[72.]
F.A. Shepherd, J. Dancey, R. Ramlau, K. Mattson, R. Gralla, M. O’Rourke, et al.
Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy.
J Clin Oncol, 18 (2000), pp. 2095-2103
[73.]
H. Anderson, R. Hopwood, R.J. Stephens, N. Thatcher, B. Cottier, M. Nicholson, et al.
Gemcitabine plus best supportive care (BSC) versus BSC in inoperable non-small cell lung cancer: a randomized trial with quality of life as the primary outcome.
Br J Cancer, 83 (2000), pp. 447-453
[74.]
G. Bepler.
Pharmacogenomics: a reality or still a promise?.
Lung Cancer, 54 (2006), pp. 3-7
[75.]
W.K. Lam, N. Watkins.
Lung cancer: future directions.
Respirology, 12 (2007), pp. 471-477
[76.]
C.A. Butler, K.M. Darragh, G.P. Curries, W.J.A. Anderson.
Variation in lung cancer survival rates between countries: do differences in data reporting contribute?.
Respir Med, 100 (2006), pp. 1642-1646
[77.]
H. Brenner.
Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis.
Lancet, 360 (2002), pp. 1131-1135
[78.]
T.-E. Strand, H. Rostad, B. Moller, J. Norstein.
Survival after resection for primary lung cancer: a population based study of 3211 resected patients.
Thorax, 61 (2006), pp. 710-715
[79.]
T. Treasure, M. Ytley.
Survival after resection for primary lung cancer.
Thorax, 61 (2006), pp. 649-650
[80.]
J. Pfannschmidt, T. Muley, H. Bülzebruck, H. Hoffmann, H. Dienemann.
Prognostic assessment after surgical resection for non-small cell lung cancer: experiences in 2083 patients.
Lung Cancer, 55 (2007), pp. 371-377
[81.]
H. Asamura, T. Goya, Y. Koshiishi, Y. Sohara, K. Eguchi, M. Mori, et al.
A Japanese lung cancer registry study. Prognosis of 13010 resected lung cancers.
J Thorac Oncol, 3 (2008), pp. 46-52
[82.]
C.F. Mountain.
Revisions in the International System for staging lung cancer.
Chest, 111 (1997), pp. 1710-1717
[83.]
F.G. Aragoneses, N. Moreno, P. León, E. García-Fontán, E. Folqué, Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S).
Influence of delay on survival in the surgical treatment of bronchogenic carcinoma.
Lung Cancer, 36 (2002), pp. 59-63
[84.]
M.A. Cañizares Carretero, J.E. Rivo Vázquez, M. Blanco Ramos, A. Toscano Novella, E.M. García Fontán, M.J. Parriños Hermida.
Influencia de la demora quirúrgica en la supervivencia de los pacientes intervenidos por carcinoma broncogénico.
Arch Bronconeumol, 43 (2007), pp. 143-149
[85.]
S. Janes, S. Spiro.
Are we achieving the current waiting time targets in lung cancer treatment?.
J Thorac Oncol, 2 (2007), pp. 588-589
[86.]
M.P. Devbhandari, M.N. Bittar, P. Quennell, P. Barber, P. Krysiak, R. Shah, et al.
Are we achieving the current waiting time targets in lung cancer treatment? Results of a prospective study from a large United Kingdom teaching hospital.
J Thorac Oncol, 2 (2007), pp. 590-592
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