International Journal of Epidemiology, Vol 19, S14-S23, Copyright © 1990 by International Epidemiological Association
LC Koo and JH Ho
A review of published reports on lung cancer was done to describe its
worldwide epidemiological pattern and to elucidate the contribution of
smoking and nonsmoking risk factors in its aetiology. Among lung cancer
patients, roughly 98% of males worldwide, and 70-90% of European and
American females, reported a history of smoking. Asian women had much lower
(6-57%) rates of smoking. Mortality rates among female nonsmokers showed
about a four-fold difference, being lowest in India and Japan, intermediate
in the USA, and highest among the Chinese. There was some indication that
incidence rates among nonsmokers may have increased in some societies in
this century. The usefulness of histological comparisons among nonsmokers
seemed limited since its distribution did not vary by place or ethnicity;
about 70% were adenocarcinomas. In Western populations, younger lung cancer
patients were more likely to have been smokers, whereas the opposite was
true in Asian populations. Thus the epidemiological patterns of lung cancer
in Western and non- Western societies are likely to be different, with
nonsmoking risk factors being more important among women in general, and
Asian women in particular.
ARTICLES
Worldwide epidemiological patterns of lung cancer in nonsmokers
Lung Cancer Research Unit, Nam Long Hospital, Wong Chuk Hang, Hong Kong.
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