Chapter 29 - Lung and Bronchus Carcinoma, Total (All Types)

Abstract

This chapter focuses on lung and bronchus carcinoma. The most important cause of lung cancer by far is cigarette smoking. Other causes include pipe and cigar smoking, passive exposure to the smoke coming from the cigarettes of others, and less common causes of lung cancer that one encounters in the workplace. These include arsenic, certain nickel compounds, hexavalent chromium, chloromethyl ethers (BCME or CMME), mustard gas, asbestos, and polycyclic hydrocarbons. Radon, a radioactive gas, is emitted from certain geological formations and appears in some mines and even in homes in some parts of the country. Lung cancer has resulted from exposure to other forms of ionizing radiation, such as that from outmoded high-dose radiation treatments or the atomic bomb. Other workplace exposures strongly suspected of causing lung cancer are silica, beryllium fumes, acrylonitrile, ferric oxide, sulfuric acid mist, epichlorohydrin, and lead and cadmium dusts. Consumption of fruits and vegetables has been reported to decrease the frequency of lung cancer. There are clear genetic factors that increase and decrease susceptibility, sometimes in interaction with dietary items. Cancer of the lung and bronchus is twice as frequent among men as women, and appears in Los Angeles County as frequently as in other parts of North America and Europe, although Utah enjoys lower rates. The patterns conform to the distribution that is expected on the basis of the known variations in smoking experience, with the highest risk seen in areas that are predominately African-American or of lower social class.