Time trends of lung cancer incidence by histologic types and smoking prevalence in Hong Kong 1983-2000

The gender difference in epidemiology of lung cancer has been postulated to be due to the higher susceptibility of women to risk factors especially tobacco smoking. Alternatively, such difference may also be explained by some unknown gender-specific etiological factors, which can have been masked if both the female and male prevalence of smoking are high. Hong Kong has a low female smoking prevalence rate and therefore the trend of the female incidence of lung cancer is particularly interesting because it can reflect the effects of the non-smoking related risk factors more clearly. The present study examined the trends of incidence rates for the major histologic types and smoking prevalence from 1983 to 2000 in Hong Kong with respect to gender. The prevalence of daily smokers decreased from 39.7% in 1982 to 22% in 2000 in males and from 5.6 to 3.5% in females. The time trends of the lung cancer incidence (overall or with respect to age and histology) were similar for both genders. The overall incidence decreased progressively throughout the study period, attributable to the decrease in squamous cell, small cell and large cell carcinoma. The decline occurred in all age groups but to a greater extent in the younger age groups. The incidence of adenocarcinoma increased until 1988-1990 and then stabilized. The initial increase was restricted to the older age groups. These temporal patterns suggested that the same etiological factors affected both genders to a different extent but manifested as similar changes in the direction of incidence over time. To confirm this hypothesis, further studies were needed to clarify the nature of these etiological factors for the non-smoking related lung cancer cases.     

Changing trends in incidence of lung cancer by histologic type in Scotland

Lung cancer is a major public health concern worldwide. Our study aims to examine trends in incidence of lung cancer in Scotland during 1959-97 and by histologic type for 1975-97. In Scotland, lung cancer is the most commonly diagnosed cancer in men and is the second most commonly diagnosed cancer in women. Due to poor survival rates, trends in incidence and mortality display similar patterns. Within the United States and many parts of Europe, falls in the incidence of squamous cell carcinoma have occurred whilst the incidence of adenocarcinoma has increased. Data were extracted from the Scottish Cancer Registry. Trends in incidence were examined by standardising rates to the World Standard Population. Age-specific rates were examined by year of diagnosis and mid year of birth. In Scotland the incidence of lung cancer in men has fallen since the late 1970s, whereas incidence in women has continued to increase. Incidence rates of adenocarcinoma have increased over time but squamous cell carcinoma remains the predominant type of lung cancer in Scotland. The quality of lung cancer registration data has improved over time, although a large proportion of lung cancers (>20%) are not microscopically verified. Changes in histologic types are unlikely to be solely due to diagnostic advances. Rates of adenocarcinoma have increased steadily over time, and this may be due to changes in cigarette design during the 1950s.     

Expression of epidermal growth factor receptors in four histologic cell types of lung cancer

Lung cancer tissues from 68 patients were examined for epidermal growth factor (EGF) receptor levels and EGF receptor gene copy numbers. Histologic cell types of these lung cancer tissues included squamous-cell carcinoma (n = 30), adenocarcinoma (n = 28), large-cell carcinoma (n = 4), and small-cell carcinoma (n = 6). Tissues of squamous-cell carcinoma exhibited exceptionally high 125I-EGF binding activity, and those of small-cell carcinoma showed no EGF binding activity. Southern blot hybridization analysis revealed EGF receptor gene amplification in the squamous-cell carcinomas with high EGF binding activity. The EGF receptor levels in squamous-cell carcinomas and adenocarcinomas were compared with their pathological staging grouping and pathological findings, including degree of differentiation, diameter of tumor, and lymph node metastasis. However, unlike previous reports on breast and bladder cancers, there was no obvious correlation between these pathological characteristics and the EGF receptor levels of lung cancer.     

Asbestos exposure and histologic cell types of lung cancer in surgical and autopsy series

A case-control study was carried out on 41 surgical and 106 autopsy histological tissue samples of lung cancer in men, in order to investigate the relationships between asbestos exposure and cell type of pulmonary carcinoma. Both occupational history (obtained by interviews of surgical patients or of the next-of-kin for deceased subjects) and lung asbestos body content (determined by optical count after hypochlorite digestion and membrane filtration of lung tissues) were considered as asbestos exposure indicators. No significant relationships were found in the surgical series after adjustment for smoking. The autopsy series showed a trend towards an association between lung adenocarcinoma and asbestos exposure indicators and a markedly higher agreement between the 2 kinds of indicators than that observed in the surgical series.     

WWOX expression in different histologic types and subtypes of non-small cell lung cancer.

PURPOSE: Non-small cell lung cancer (NSCLC) has heterogeneous histopathologic classification and clinical behavior and very low survival rate. WWOX (WW domain-containing oxidoreductase) is a tumor suppressor gene, and its expression is altered in several cancers. The purpose of this study is to better define the role of WWOX in NSCLC tumorigenesis and progression by determining its pathogenetic and prognostic significance. EXPERIMENTAL DESIGN: WWOX protein expression was evaluated by immunohistochemistry in 170 patients with NSCLC (101 squamous cell carcinomas, 66 adenocarcinomas, 3 large cell carcinomas) and was correlated with histopathologic (histotype, subtype, grade, tumor-node-metastasis, stage, index of cell proliferation Ki67/MIB1) and clinical (age, gender, local recurrences, distant metastases, overall survival, and disease-free survival) characteristics. RESULTS: WWOX expression was absent/reduced in 84.9% of NSCLCs, whereas it was normal in 80.5% of adjacent normal lung tissues. WWOX expression was strongly associated with tumor histology (P=1.1x10(-5)) and histologic grade (P=0.0081): the percentage of cases with absent/strongly reduced WWOX expression was higher in squamous cell carcinomas and in poorly differentiated tumors. Regarding adenocarcinoma, bronchioloalveolar pattern showed normal WWOX expression in 62.5% of the cases, whereas in solid and acinar patterns, a prevalence of cases with absent/very low WWOX expression was observed (79.2% and 50%, respectively). Finally, weak WWOX staining intensity was related to the high index of cell proliferation (P=0.0012). CONCLUSIONS: Our results suggest that the loss of WWOX expression plays different roles in tumorigenesis of distinct histotypes and subtypes of NSCLC and is related to high aggressiveness (G3; high proliferating activity) of tumors.     

Disparate survival trends in histologic subtypes of metastatic non-small cell lung cancer: a population-based analysis

Erlotinib, bevacizumab, and pemetrexed improved survival of metastatic non-small cell lung cancer (mNSCLC) in clinical trials, but their benefits are restricted to non-squamous histology. We studied recent survival trends in mNSCLC subpopulations defined by histology and associated clinical factors correlating with adenocarcinoma or endothelial growth factor receptor mutations. Using the Surveillance, Epidemiology and End Results database, we calculated relative survival at 1 year from diagnosis for mNSCLC cases diagnosed in 2000-2011. Trends by histology, age, sex, race, prevalence of smoking or poverty, expressed as annual percent change (APC) using joinpoint regression, were compared by test of slope parallelism (P_par). Among 226,446 cases, 47% had adenocarcinoma, 20% squamous carcinoma, 6% other, and 27% unspecified histology. The proportion of cases designated as adenocarcinoma significantly increased after 2005. One-year survival increased from 23.5% in 2000 to 30.5% in 2010, significantly more for adenocarcinoma (APC, 3.3%) than squamous carcinoma (APC, 2.1%, P_par=0.0018). For patients with adenocarcinoma, these trends were significantly better for Asians than Whites (P_par=0.012) and for areas with fewer smokers (P_par=0.014). Such differences were not observed for squamous carcinoma (P_par=0.87 and 0.14, respectively). The absolute disparity in one-year survival between adenocarcinoma and squamous carcinoma increased from 1.6% in 2000 to 5.5% in 2010. The disparity between Asians and Whites increased from 5.2% to 13.1%, respectively. These data demonstrate that improvement in survival of mNSCLC since 2000 is now evident on a population scale. The superior increment for patients with adenocarcinoma, particularly among Asians and in communities with fewer smokers, suggests impact of the newly introduced, histology-specific agents, rather than better supportive care alone. Growing disparities between adenocarcinoma and squamous carcinoma highlight the needs to intensify research on treatment for subgroups that did not benefit from recent advances.     

Changing trends in histologic types of lung cancer during the last decade (1981–1990) in Korea: a hospital-based study

A review of the histopathology and past history of 2229 patients with primary lung cancer diagnosed at the Yonsei University Medical Center from 1981 to 1990 was performed to investigate the changes in histologic types and the relationship to smoking history. The most frequent histologic type of lung cancer was squamous cell carcinoma (956 patients, 54.0%) followed by adenocarcinoma (311 patients, 17.6%) in males (1772 patients), and adenocarcinoma (206 patients, 45.1%) followed by squamous cell carcinoma (126 patients, 27.6%) in females (457 patients). In both sexes, the predominant type was adenocarcinoma under the age of 40, whereas squamous cell carcinoma was the most frequent type above the age of 40. While squamous cell carcinoma decreased over 10 years (54.3% in 1981, 44.3% in 1990), adenocarcinoma showed a gradually increased incidence (17.0% in 1981, 28.3% in 1990) in both sexes, and the proportion of small cell carcinoma and large cell carcinoma remained unchanged. These changes in histologic type were more prominent in non-smokers. In conclusion, the increasing incidence of adenocarcinoma in both sexes, especially in non-smokers, suggests the possible presence of etiologic factors other than smoking, such as environmental pollution.     

Secular trends in cancer mortality, California 1970-1998

BACKGROUND: Monitoring mortality is a meaningful way to evaluate the effectiveness of cancer control activities. Results of trend analysis for cancer related deaths by race/ethnicity in California from 1970 to 1998 are reported here. METHODS: Age-adjusted cancer mortality rates in California were used in the analysis of secular trends. Mortality patterns for selected cancers in all races combined are compared with similar patterns in the US for 1973-1998. RESULTS: The overall cancer mortality rates in California began to decline in 1987 in both men and women. Although mortality trends by site, sex, and race/ethnicity showed significant variations, the overall pattern in California is heavily influenced by trends for the non-Hispanic white (NHW) population and is very similar to the patterns in the US with minor differences in the magnitude and trend. CONCLUSIONS: This is the first time that secular trends in cancer mortality for California are presented by race and ethnicity. Despite notable racial differences, the overall trend follows a declining pattern. Detailed explanation of the reasons behind the observed patterns is not included in this report. Some of the differences between California and the US, however, can be explained by differences in the racial and ethnic composition of the two populations. Approximately 45% of the California population has Hispanic (HSP) or Asian origins among whom cancer mortality rates are substantially lower. Another factor is the difference in the intensity and coverage of cancer related activities such as tobacco control. Prevalence of smoking in California is much lower than the rest of the US.     

A population-based study of lung cancer incidence trends by histologic type, 1974-81

All incident cases of microscopically confirmed lung cancer diagnosed between 1974 and 1981 in western Washington State were identified through the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, Bethesda, MD. The incidence of lung cancer by histologic type was studied in relation to time, with age, sex, and stage of disease at diagnosis being taken into account. Overall and within each sex, the incidence of adenocarcinoma has increased significantly since 1974. The rate of increase has been higher among females (86% increase) than among males (54% increase), with most of the increase in both sexes being among those over age 65 years with distant or unstaged disease at diagnosis. Similar patterns were not observed for squamous cell carcinoma. The potential effects of changes in diagnostic and pathology practice during the study period in producing these results were explored, and etiologic implications of the observed increase in adenocarcinoma were discussed.     

Significant changes in the distribution of histologic types of lung cancer. A review of 4928 cases

The histopathologic data for lung carcinoma were reviewed in 4928 patients between 1964 and 1985. The analysis of this data indicates that lung cancer is increasing in our region. Squamous carcinoma remains the most frequent type in men, followed by adenocarcinoma. Small cell carcinoma is the second most frequent type in women, after adenocarcinoma. Small cell carcinoma has increased over the past years and may become the most common type of lung cancer in women, a development that might result in increased numbers of deaths. Lung cancer data must be carefully analyzed in view of the impact on selection of therapy, patient management, and education.     

Transfer factor immunochemotherapy for primary lung cancer--evaluation of histologic types

The clinical effect of leucocyte dialysate, including Transfer Factor (TF), on different histologic types of primary resected lung cancer was studied. This TF immunotherapy protocol included 171 patients. Eligible cases for evaluation were randomly chosen; the TF group and control group consisted of 75 and 74 patients, respectively. The TF group included 40 adenocarcinomas, 29 epidermoid carcinomas and 6 other histologic types of carcinoma. The control group included 42 adenocarcinomas, 25 epidermoid carcinomas and 7 other histologic types of carcinoma. The distribution of clinical features in the TF and control group was very similar, not only in adenocarcinoma but also in epidermoid carcinoma. The postoperative follow-up term was 2 to 55 months in both groups. Survival in the TF group of patients with adenocarcinoma of stages I + II or curative resection was significantly better than in the control group (p less than 0.005, Cox-Mantel test). There was no significant intergroup difference in patients with stages III + IV, relative curative or noncurative resection. Survival in the TF group of patients with epidermoid carcinoma of stages I + II or III + IV was about 20% better than in the control, however, there was no significant difference between the 2 groups. On the other hand, survival in the TF group of patients undergoing relative curative resection was significantly better than in the control (p less than 0.005, Cox-Mantel test). There was no significant difference among patients who underwent curative or noncurative resection. Time-versus-recurrence curves were evaluated by the Kaplan-Meier method; there was a significant difference between patients with stages I + II, but not between patients with stages III + IV. The frequency of recurrence of regional or intrapulmonary distant metastasis was lower in the TF group. It is suggested that TF suppresses postoperative recurrence and that it may be beneficial as postoperative adjuvant immunochemotherapy in primary resected lung cancer patients, especially those with relatively early stage cancer.     

Recent trends in different histological types of lung cancer in Tokyo based on pathological autopsy records

The recently increasing trend of lung cancer mortality in Japan was qualitatively analyzed. As the percentages of cases undergoing pathological autopsies in Tokyo were thirty for males and twenty-six for females during the period from 1979 to 1983, the histologically classified death rates in Tokyo could be estimated by combining the reported cases of death from lung cancer with the proportion of these of known histological type. The results indicated an increase in adenocarcinoma, and a decrease in squamous-cell carcinoma, except for the older age-group of men. The latter result suggested that the results were affected by the decreasing proportion of smokers and by the improvement in cigarette quality. The increase in small-cell and large-cell carcinoma, and the decrease in undifferentiated carcinomas, could be explained by problems associated with differing diagnostic standards. However, when these three different types of carcinoma were considered as a single type, the death rate was shown to be increased except in younger age-groups of women.     

Clinical characteristics of different histologic types of breast cancer

Breast cancer is a heterogeneous disease, though little is known about some of its rarer forms, including certain histologic types. Using Surveillance, Epidemiology, and End Results Program data on 135 157 invasive breast cancer cases diagnosed from 1992 to 2001, relationships between nine histologic types of breast cancer and various tumour characteristics were assessed. Among women aged 50-89 years at diagnosis, lobular and ductal/lobular carcinoma cases were more likely to be diagnosed with stage III/IV, > or =5.0 cm, and node-positive tumours compared to ductal carcinoma cases. Mucinous, comedo, tubular, and medullary carcinomas were less likely to present at an advanced stage. Lobular, ductal/lobular, mucinous, tubular, and papillary carcinomas were less likely, and comedo, medullary, and inflammatory carcinomas were more likely to be oestrogen receptor (ER) negative/progesterone receptor (PR) negative and high grade (notably, 68.2% of medullary carcinomas were ER-/PR- vs 19.3% of ductal carcinomas). In general, similar differences were observed among women diagnosed at age 30-49 years. Inflammatory carcinomas are associated with more aggressive tumour phenotypes, and mucinous, tubular, and papillary tumours are associated with less aggressive phenotypes. The histologic types of breast cancer studied here differ greatly in their clinical presentations, and the differences in their hormone receptor profiles and grades point to their likely different aetiologies.     

Epidemiologic patterns in lung cancer by histologic type

Three thousand and ninety-seven lung cancer patients interviewed in different U.S. hospitals in 1977–1984 were classified into Kreyberg I and Kreyberg II categories. In both sexes, Kreyberg II patients were found to be younger and more frequently Jewish; among the male patients only, Kreyberg II cases were higher in educational and occupational level. These differences remained when the effect of cigarette smoking was controlled. Study data showed an increase in the frequency of Kreyberg II cases over time, and significantly, a decrease with younger age of the Kreyberg I: Kreyberg II ratio in both sexes. It is concluded that the observed secular increase in Kreyberg II is real and not merely due to changes in diagnostic methodology. On the basis of demographic differences noted, possible etiologic factors that may have contributed to the recent changes in lung cancer distribution by cell type are suggested.     

A normal adult and fetal lung antigen present at different quantitative levels in different histologic types of human lung cancer.

Rabbits were immunized with extract of either an adenocarcinoma of the lung, or one of three oat cell carcinomas of the lung. Unabsorbed and variously absorbed antisera, and various extracts, were analyzed by double and radial immunodiffusion. The adenocarcinomas-antisera identified an antigen subsequently quantitated at high concentration in seven adenocarcinomas of the lung, but a low concentration in five normal adult and four fetal lungs. Three of four epidermoid carcinomas of the lung contained the antigen at low concentration, however only trace amounts were detected in four of five oat cell carcinomas of the lung. The oat cell carcinoma-antisera failed to identify a significant antigen. Quantitatively, the above antigen appeared to distinguish adenocarcinomas and to a lesser extent epidermoid carcinomas from oat cell carcinomas of the lung, and to be consistent with the concept that oat cell carcinomas arise from a different cell type than the other lung tumors.