Trends in incidence of small cell lung cancer and all lung cancer

doi:10.1016/j.lungcan.2011.08.004

Lung Cancer

Volume 75, Issue 3, March 2012, Pages 280-284

https://doi.org/10.1016/j.lungcan.2011.08.004 Get rights and content

Abstract

Background

The incidence of small cell lung cancer (SCLC) is often quoted as ‘around 20%’ of all lung cancers but is reportedly decreasing over time. We analysed the trends in incidence of SCLC and compared these with the trends in lung cancer overall among males and females in South East England.

Methods

We identified 237,792 patients diagnosed with lung cancer (ICD-10 C33-C34) between 1970 and 2007. We used a Poisson regression age-cohort model to estimate the age-specific rates in the 1890–1960 birth cohorts. We computed age-standardised incidence rates using the European standard population. In addition, we analysed the trends of lung cancer subtypes according to morphology.

Results

In the most recent time period, SCLC accounted for 10% and 11% of cases of all lung cancer among males and females, respectively. Among the morphologically specified lung cancers, SCLC accounted for 15% and 17% among males and females, respectively. There was a decrease of SCLC incidence over time and by birth cohort in both sexes. The decrease in SCLC was more marked than that in all lung cancers.

Conclusion

The decrease in SCLC incidence rates may reflect decreases in the prevalence of cigarette smoking, and changes in the type of cigarettes smoked.

Introduction

Lung cancer is the second most common cancer in both males and females in the UK, but is more common in males than females with a cumulative life-time risk of 5% and 3%, respectively [1]. Whereas the incidence rate in males has fallen by 47% between 1975 and 2006, from 113 to 61 per 100,000, the rate in females has risen by 65% during the same time period, from 23 to 38 per 100,000 [2].

The different morphological types of lung cancer are divided into two main groups, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLC is usually reported to comprise about 20% of all lung cancer cases recorded [2]. SCLC is strongly associated with cigarette smoking. The reduction in prevalence of smoking and change in tobacco products smoked can therefore be expected to lead to a decrease in the incidence of SCLC over time [3], [4], [5].

Herein, we analyse the trends in incidence of SCLC among males and females over time and between birth cohorts, and compare these with the trends in lung cancer overall.

Section snippets

Patients and methods

From the Thames Cancer Registry (TCR) database, we identified 237,810 patients diagnosed with lung cancer (ICD-10 C33-C34) between 1970 and 2007. The TCR is one of 12 population-based cancer registries in the United Kingdom and covers the residential population of London, Surrey, Sussex and Kent. In this area, registration is initiated by pathology and clinical information received from hospitals. Trained cancer registration officers seek additional information from the medical records on

Results

More males than females were diagnosed with both lung cancer and SCLC (Table 1). There was a gradual decline in the proportion of male patients compared to female patients with lung cancer from 1972 to 2007 (Table 2). We observed a decline in absolute numbers of patients with lung cancer and patients with SCLC from the late 1980s onwards, most strongly in males. Among males, the age-standardised incidence rates of lung cancer declined after 1972. In contrast, the incidence rates of lung cancer

Discussion

We found that SCLC accounts for approximately 8–10% and 10–13% of all new cases of lung cancer among males and females, respectively. We observed a decrease of SCLC numbers and rates over time and over successively recent birth cohorts among males, whereas a less pronounced decrease was observed in females.

A limitation of our study is the large percentage of cancers with unspecified morphology, which declined over the period of analysis. We calculated the proportion of SCLCs in comparison to

Ethics

Cancer registries in England have approval from the National Information Governance Board to carry out surveillance using the data they collect on all cancer patients under section 251 of the NHS Act 2006. Therefore separate ethical approval was not required for this study.

Role of funding source

The authors declare that the study sponsors had no involvement in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript or in the decision to submit the manuscript for publication.

Conflict of interest statement

In the last 12 months Michael D. Peake has received honoraria for lecturing and educational events from: AstraZeneca, Eli Lilly and Roche Pharmaceuticals. In addition he has received support for travel to scientific conferences from: Roche Pharmaceuticals, Eli Lilly, Boehringer Ingelheim Ltd. and Pierre Fabre Oncology.

James Spicer has received honoraria from Boehringer Ingelheim, Roche and AstraZeneca.

Acknowledgments

This paper is a contribution from the National Cancer Intelligence Network and is based on the information collected and quality assured by the regional cancer registries in England (www.ukacr.org; www.ncin.org.uk).

The authors acknowledge financial support from the Department of Health via the National Institute for Health Research (NIRR) comprehensive Biomedical Research Centre award to Guy's & St Thomas’ NHS Foundation Trust in partnership with King's College London and King's College

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Trends in incidence of small cell lung cancer and all lung cancer

Abstract

Background

Methods

Results

Conclusion

Introduction

Section snippets

Patients and methods

Results

Discussion

Ethics

Role of funding source

Conflict of interest statement

Acknowledgments

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Lung Cancer

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Lung Cancer

Ann Diagn Pathol

Chest

GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10

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

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