International Journal of Epidemiology, Vol 26, 14-23, Copyright © 1997 by International Epidemiological Association
A Charloux, E Quoix, N Wolkove, D Small, G Pauli and H Kreisman
Lung adenocarcinoma is the most common cell type in females (smokers or
non-smokers) and in non-smoking males. Its incidence has been increasing in
younger cohorts of males and females until very recent years. Changes in
classification and in pathological techniques account for some of this
increase. In females and non-smoker males, the increase could be partly due
to a detection bias in former studies. Nevertheless, successive cohorts
over time seem more likely to develop adenocarcinoma and less likely to
develop squamous cell carcinoma. These differences between birth cohorts
suggest that the increasing incidence of adenocarcinoma is not only due to
changes in pathological diagnosis. Geographical differences are also
observed: in Europe, the squamous cell type still predominates and an
increase in incidence of adenocarcinoma has only been reported in the
Netherlands. In Asia, in the 1960s and 1970s, the proportion of
adenocarcinoma was higher than in North America or Europe and seems to be
increasing. To what extent these differences are due to differences. In
establishing diagnosis remains unknown. Despite these biases in temporal
and geographical trends detailed in this review, there has probably been a
true increase in incidence of adenocarcinoma. An explanation for this
should be sought in studies on detailed smoking history and passive smoking
exposure, occupational exposure, diet and cooking, pollution and other
environmental factors.
ARTICLES
The increasing incidence of lung adenocarcinoma: reality or artefact? A review of the epidemiology of lung adenocarcinoma
Pulmonary Division, Jewish General Hospital, McGill University, Montreal, (Quebec), Canada.
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