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Pretreatment evaluation of non-small-cell lung cancer. The American Thoracic Society and The European Respiratory Society.

At the beginning of the 20th century lung cancer was a rare malignancy. It is now occurring in epidemic proportions worldwide. It is the most common cause of death from malignancy in the United States, the United Kingdom, and a number of other countries. The rate of lung cancer in women in the United States is increasing, while the rate in males is beginning to decline, especially in those less than 50 yr of age. Women account for 40% of all lung cancer cases, and lung cancer has surpassed breast cancer as the most common cause of death from malignancy. Smoking is the predominant risk factor associated with lung cancer. The risk is related to the number of cigarettes smoked, age at starting smoking, and the duration of smoking (see ATS statement on cigarette smoking and health. 1996. Am. J. Respir. Crit. Care Med. 153:861-865). It is estimated that smoking accounts for 80-90% of all cases of lung cancer. The vast majority of cases could be prevented by never smoking, and the risk of developing lung cancer could be lessened by smoking cessation. Lung cancer is easier to prevent than cure.