New Cases Of Lung Cancer Research Articles

Phase I/II trial of anti-PD-1 checkpoint inhibitor nivolumab and 177Lu-DOTA0-Tyr3-Octreotate for patients with extensive-stage small cell lung cancer.

TPS8589Background: Small cell lung cancer (SCLC) accounts up to 15% of all new cases of lung cancer. 60% of patients with SCLC present with extensive-stage SCLC (ES-SCLC). Despite initial sensitivi...

Consensus statement on a screening programme for the detection of early lung cancer in Poland.

Lung cancer is the most common cancer in Poland and worldwide, and the leading cause of cancer-related deaths. Compared to the present day, the annual number of new cases of lung cancer will have increased by approximately 50%, by 2030. The overall ratio of mortality to incidence totals 0.87 and is among the highest. The five-year survival rate in Poland has recently achieved 13.4%. In 2015, lung cancer screening using low-dose computed tomography (LDCT) was introduced to routine clinical practice in the United States following the publication of the largest randomised study, The National Lung Screening Trial. The implementation of screening programmes in Poland and the rest of Europe also seems unavoidable. Due to the differences, both in the socioeconomic considerations and healthcare funding, compared to that in the United States, the current approach comes down to the awaited results of the European randomised study, NELSON. During the meeting of an expert panel at the "Torakoneptunalia 2016" conference in Jastarnia, Poland, a decision was made to summarise and publish the current data on LDCT lung cancer screening in the form of recommendations, or a position statement. The document was prepared by a team composed of a radiologist, thoracic surgeons, pulmonologists, clinical oncologists, epidemiologists, internists, health prevention specialists and pathologists. It reflects the current body of knowledge about lung cancer, its diagnosis and treatment, and provides recommendations on early detection of lung cancer using LDCT. The recommendations address the screening procedure, the requirements for the teams conducting the screening, and the requirements for radiologists, pathologists and surgeons involved in the diagnosis and treatment of patients. While awaiting the results of the NELSON study and the European position statement on lung cancer screening methodology, the multidisciplinary group of experts presents their position, laying grounds for the development of an action plan for early detection of lung cancer in the upcoming future in Poland. Primary and secondary prophylaxis are the principal ways to reduce lung cancer mortality. While smoking cessation is a task of utmost importance, it must be accompanied by an effective screening programme if the outcome of the disease is to be improved.

Lung cancer incidence and the strength of municipal smoke-free ordinances.

Smoke-free laws reduce disease prevalence. The impact of municipal smoke-free laws on lung cancer incidence in Kentucky was examined. The authors hypothesized that lung cancer incidence rates would be associated with the strength of smoke-free laws. This was a secondary analysis of 83,727 Kentucky residents aged ≥ 50 years who were newly diagnosed with lung cancer from 1995 to 2014. In 2014, 33 municipalities had 1 or more smoke-free laws. County-level characteristics included adult smoking rate, sex, race/ethnicity, income, physician supply, observed radon values, and rurality. Individuals living in communities with comprehensive smoke-free laws were 7.9% less likely than those living in communities without smoke-free protections to be diagnosed with lung cancer. The difference in lung cancer incidence between counties with moderate/weak laws and those without laws was not significant. Comprehensive smoke-free laws were associated with fewer new cases of lung cancer, whereas weak or moderate smoke-free laws did not confer the same benefit. One hundred percent smoke-free laws, covering all workers and the public with few or no exceptions, may be key in reducing new cases of lung cancer. Cancer 2018;124:374-80. © 2017 American Cancer Society.

P1.06-018 EGFR Mutations and ALK Gene Rearrangements: Changing Patterns of Molecular Testing in Brazil

Lung cancer is the leading cause of cancer death worldwide. In Brazil, cancer is the second most common cause of death and there were an estimated 27,330 new cases of lung cancer in 2014. Targeted therapies have changed disease prognosis and current clinical guidelines advocate for testing all patients with advanced disease for EGFR mutations and ALK gene rearrangements. Access to this testing is often limited in the developing world. In the case of Brazil, there is limited data regarding the frequency of testing and the changes in patterns of testing overtime.

The role of the ataxia telangiectasia mutated gene in lung cancer: recent advances in research.

Lung cancer is the leading cause of death due to cancer worldwide. It is estimated that approximately 1.2 million new cases of lung cancer are diagnosed each year. Early detection and treatment are crucial for improvements in both prognosis and quality of life of lung cancer patients. The ataxia telangiectasia mutated (ATM) gene is a cancer-susceptibility gene that encodes a key apical kinase in the DNA damage response pathway. It has recently been shown to play an important role in the development of lung cancer. The main functions of the ATM gene and protein includes participation in cell cycle regulation, and identification and repair of DNA damage. ATM gene mutation can lead to multiple system dysfunctions as well as a concomitant increase in tumor tendency. In recent years, many studies have indicated that single nucleotide polymorphism of the ATM gene is associated with increased incidence of lung cancer. At the same time, the ATM gene and its encoding product ATM protein predicts the response to radiotherapy, chemotherapy, and prognosis of lung cancer, thus suggesting that the ATM gene may be a new potential target for the diagnosis and treatment of lung cancer.

Implementation of molecular testing for EGFR mutations and ALK rearrangement in lung adenocarcinoma in Brazil.

e18002 Background: Lung cancer is the leading cause of cancer death worldwide. In Brazil, cancer is the second most common cause of death and there were an estimated 27,330 new cases of lung cancer in 2014. Targeted therapies have changed disease prognosis and current clinical guidelines advocate for EGFR/ALK molecular testing for all patients with advanced-stage lung adenocarcinoma. Access to this testing is often limited in the developing world. In the case of Brazil, there is limited data regarding the frequency of testing and the changes in patterns of testing overtime. Methods: De-identified data was obtained from a commercial database that surveys approximately 2,000 cancer physicians in Brazil regarding practice patterns. On average 300 physicians responded to the survey, which is conducted every 6 months, and provided information on about 18,000 patients. Subsequently, we identified patients with lung cancer and calculated the frequency of testing for EGFR mutations and ALK rearrangement from 2011 to 2016. Results: 11,684 patients with lung adenocarcinoma were analyzed from 2011 to 2016. The frequency of testing for EGFR mutations increased significantly: 12.8% (287/2,228) in 2011, 34.4% (738/2,142) in 2012, 39.2% in 2013 (822/2,092), 43.9% in 2014 (866/1,972), 53.3% (1165/2,184) in 2015, and 58% (626/1,066) for the first semester of 2016. Testing for ALK rearrangement also increased noticeably over the same period: 0% in 2011 (0/2,228) and 2012 (0/2,142), 0.9% (19/2,092) in 2013, 2.99% (59/1,972) in 2014, 5.5% (121/2,184) in 2015, and 4.8% (52/1,066) for the first semester of 2016. Conclusions: To our knowledge this is the largest data analysis regarding changing practice patterns of molecular testing for lung adenocarcinoma over time in Brazil and Latin America. The frequency of testing for EGFR mutations and ALK rearrangement has increased over the last 5 years but is still below the current guidelines recommending that all patients with advanced disease be tested. Further understanding of the barriers to testing, will hopefully lead to national strategies for universal implementation of molecular testing.

P1.07-032 Most Common Genomic Alterations in SCLC

Lung cancer is the leading cause of cancer death in US. The American Cancer Society’s estimates for lung cancer in the United States for 2016 are: approx 224,390 new cases of lung cancer and approx 158,080 deaths. Approximately 10-15% of lung cancers are classified as small cell (SCLC). These cancers portend a poor prognosis. Genomic sequencing of non-small cell lung cancer led to developing of new therapeutic modalities, i.e. targeted therapy with superior results to conventional cytotoxic chemotherapy. At this time, there is no approved targeted therapy for SCLC. In order to develop targeted therapies we need to identify and characterize molecular targets (alterations). This study aims to report our experience with genomic sequencing of SCLC. We performed a retrospective analysis of a dataset of 54 cases of SCLC, who underwent genomic sequencing. Patients were treated at 5 tertiary referral centers, between October 2012 and June 2016. The recorded data included: age at diagnosis, date of the genomic sequencing, genomic alteration (affected genes and the type of molecular alteration identified). For genomic profiling we used a platform commercially available (FoundationOne). We obtained 54 samples from 54 patients. Age range is 42 to 75 years, mean 60 and median 61 years old. All cases had a histologic diagnosis of SCLC. The genomic analysis found 88 affected genes with 230 alterations. The most common affected genes: Tp53 alteration, 45 cases (83%) and Rb1 33 cases (61%). There were an average of 4.3 mutations per patient; with a median of 4 mutations per patient, with a minimum of 0 and a maximum of 13. Sustained investigations and sequencing of larger numbers of SCLC are aiming to identify potential actionable mutations in these tumors. The ultimate goal is to determine new therapies and optimal treatment strategy based on the genomic profile.

SC19.04 Endobronchial Palliation in Thoracic Malignancies

Lung cancer is the second most common cancer in both men and women; in men prostate cancer, while in women breast cancer is more common. About 14% of all new cancers are lung cancers. The American Cancer Society’s estimates for lung cancer in the United States for 2016 are: About 224,390 new cases of lung cancer (117,920 in men and 106,470 in women) About 158,080 deaths from lung cancer (85,920 in men and 72,160 in women) Lung cancer is by far the leading cause of cancer death among both men and women; about 1 out of 4 cancer deaths are from lung cancer. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. One third of the new lung cancer cases are candidates for surgery, and about half of the rest develops some kind of major airways involvement. This can be endobronchial tumor, extrinsic compression or combined. Besides lung cancer, metastases from other types of tumors are also candidates for intrabronchial treatments. There are different methods available for treating endobronchial malignancies, in most of the cases the combination of two or more procedure needed to reach optimal result. To reestablish the airway patency improves quality of life, and provides sufficient time to apply different lung cancer treatment, chemo, radio and immunotherapy Methods available include mechanical debulking, use of different types of laser, electrocautery, cryotherapy, intraluminal brachytherapy, argon-plasma coagulation, and microwave instruments. Different types of silicon and self-expandable metallic stents are useful for keeping the airways open after successful reopening. Balloon dilatation may help to insert stent to the compressed airways. The use of locally installed substances like chemo, different angiogenesis inhibitors are in the focus again. With the use of endobronchial ultrasound the needle can easily be inserted into the peripheral or central tumor, and lymph nodes. Most of the procedures are done under general anesthesia, with the use of rigid bronchoscope. Ideally the bronchoscopist can choose from the different methods available, using the best appropriate one in the given situation. Sufficient training is necessary before starting each new method. Simulation, low fidelity models are available to learn without having the unnecessary risk in a real case. One has to be prepared for treating different complications, such as heavy bleeding from the tumor, or bleeding caused by the procedure itself. Well trained personnel are a must to start with these kinds of procedures. Anesthesiologist, assistants trained in endoscopic procedures are essential before starting the procedure. lung cancer, bronchoscopy, palliation

Novel Genetic Algorithm for Early Prediction and Detection of Lung Cancer

Nowadays, many researchers try to find out a system that enables to detect and expect diseases early so as to find the appropriate precaution or medical treatment of it. One of the leading causes of death worldwide is Cancer. Most of the deaths from this disease are due to late prediction and detection. According to the American Cancer Society (ACS); lung cancer is the second most common cancer; it accounts for about 13% of all new cancers. It is expected to have a 221, 200 new cases of lung cancer in 2015 with 158, 040 estimated deaths from lung Cancer [1]. The main objective of this study is to reach the highest accuracy and speed of its predecessors and this is what has been obtained.

P3.07-010 Economic Evaluation of Gefitinib vs. Erlotinib for First Line in NSCLC EGFRm under the Perspective of Brazilian Health System: Topic: Therapy and Economics

About 28,220 new cases of lung cancer are going to be diagnosed in Brazil in 2016. The epidermal growth factor receptor (EGFR) is a transmembrane protein with tyrosine kinase activity associated with growth, survival, proliferation and differentiation in different human cells. Approximately 25.5% of patients with non-small lung cancer cells (NSCLC) in Brazil present activating mutations in EGFR gene, which confers sensitivity to tyrosine kinase inhibitors (gefitinib and erlotinib). Given the similarity in efficacy observed in RCTs, an economic evaluation under the perspective of the public and private sectors in Brazil was performed using a Markov model. Estimation of direct medical costs was calculated in a group of advanced NSCLC patients with EGFR mutations, undergoing first line treatment with one of the target therapies. A discount rate of 5% was applied on future costs/benefits and the rate of adverse events was extracted from a meta-analysis to estimate its costs. According to the model, patients with locally advanced or metastatic NSCLC who have EGFR activating mutations undergoing treatment first line with gefitinib required less resource versus erlotinib in both perspectives as shown in Table 1, mainly due to the price difference between the drugs (USD 984.22 versus USD 2,033.15 in the public and USD 1,440.31 versus USD 2,439.78 in the private).Table 1Estimated total costs for first line treatment with gefitinib or erlotinibStrategyTreatment Costs (USD)Incremental Costs (USD)Private SectorGefitinib26,637.12-Erlotinib42,110.0015,472.88Public SectorGefitinib16,134.00-Erlotinib32,045.4015,911.40Exchange rate 1 USD = 3.30 BRL (July/2016) Regarding costs related only to the management of adverse events, both strategies were similar in the public perspective (USD 94.15 for gefitinib versus USD 98.21 for erlotinib); however, gefitinib costs were lower than erlotinib (USD 625.27 versus USD 941.32, respectively) in the private sector. Open table in a new tab Exchange rate 1 USD = 3.30 BRL (July/2016) Regarding costs related only to the management of adverse events, both strategies were similar in the public perspective (USD 94.15 for gefitinib versus USD 98.21 for erlotinib); however, gefitinib costs were lower than erlotinib (USD 625.27 versus USD 941.32, respectively) in the private sector. First line treatment with gefitinib was dominant in comparison with erlotinib for NSCLC patients with EGFR mutation in both public and private sectors in Brazil.

P3.02a-032 Multicenter Trial of Nintedanib in Combination with Docetaxel in Metastatic Lung Adenocarcinoma: Expertise in the Real-Life Setting: Topic: Miscellaneous

In Mexico, 8,600 new cases of lung cancer are annually diagnosed, with 22 daily deaths.1 Nintedanib is a multikinase inhibitor, acts as a potent oral anti-angiogenic blocking the vascular endothelial growth factor (VEGFR 1-3), the fibroblast growth factor receptor (FGFR 1-3) and the platelet-derived growth factor receptor (PGFR α y β). The LUME-Lung 1 trial showed an improvement with docetaxel + nintedanib in overall survival of patients with lung adenocarcinoma accomplished disease control in 60.2%.4 We present a descriptive trial, with a clinical data collection of patients with advanced lung adenocarcinoma who progressed to a platinum-based, first-line treatment (± bevacizumab), included in the compassionate-use program of nintedanib, carried out between March 2014 and September 2015 in 38 medical centers in Mexico. Treatment consisted in IV dose of docetaxel 75 mg/m2 every 21 days, combined with oral nintedanib 200 mg/BID, administered from 2-21 days until maximum toxicity or disease progression. Primary Objective: Describe patients and tumors characteristics, including previous therapies. Secondary Objectives: Estimate the time under nintedanib treatment, response rate (measured by RECISTv1.1 criteria) and evaluate safety in daily clinical practice (by means of CTACAEv4 criteria). The SPSSv statistics software was used. Ninety-nine patients were included. The median of age was 59 years old, 53% were male, 51.5% were smokers, 50% had ECOG 1, 96% stage IIIB and IV, 16% had controlled brain metastases, and 85% had access to a EGFR mutational test (11% out of them positive). First-line, platinum-based chemotherapy was given to 99% of the patients, 7% were administered first-line bevacizumab, 40% receive maintenance treatment, 50% had had partial response as the best response to first-line treatment. The objective response rate was 53%, stable disease 26.5%, disease progression 16.3%, non-evaluable 4% and disease control rate of 79.6%. The combination had an adequate tolerance, mostly toxicities grades 1-2. Toxicities grade 3-4 were mainly fatigue (14%), diarrhea (13%), hiporexia (7%), neutropenia (7%), nausea (6%), vomiting (1%). Nintedanib dose was reduced in 27 patients (27%). The median duration of the treatment with nintedanib was 6.7 months. Overestimated responses may be related to the retrospective designing of the study and due to that were valued by investigator wich could influence the results. The Safety of nintedanib in real-life patients was demonstrated and not very different from the results in the LUME-Lung 1 trial. Gastrointestinal toxicity were the most frequent side effects, mostly toxicities grades 1-2.

Lung cancer in Brazil: epidemiology and treatment challenges.

Lung cancer persists throughout the world as a major cause of death. In 2014, data from the Brazilian National Cancer Institute (INCA) estimated 16.400 new cases of lung cancer among men (second most common) and 10.930 new cases among women (fourth most common). These data are consistent for all Brazilian regions and reflect the trends of cancer in the country over the last decade. Brazil is a continental country, the largest in Latin America and fifth in the world, with an estimated population of >200 million. Although the discrepancy in the national income between rich and poor has diminished in the last 2 decades, it is still huge. More than 75% of the Brazilian population do not have private health insurance and rely on the national health care system, where differences in standard of cancer care are evident. It is possible to point out differences from the recommendations of international guidelines in every step of the lung cancer care, from the diagnosis to the treatment of advanced disease. This review aims to describe and recognize these differences as a way to offer a real discussion for future modifications and action points toward delivery of better oncology care in our country.

“What’s the Risk?” Assessing and Mitigating Risk in Cardiothoracic Surgery

“What’s the Risk?” Assessing and Mitigating Risk in Cardiothoracic Surgery

Impact of lymph node occult metastases in stage I non-small cell lung cancer (NSCLC): what is the evidence?

With the improvement in imaging techniques, and the development of screening protocols for lung cancer, a growing number of patients are expected to be diagnosed with early stage non-small cell lung cancer (NSCLC). The landmark National Lung Screening Trial, gives us a hint: out of 1,060 new cases of lung cancer diagnosed in patients undergoing annual low-dose chest computed tomography screening and 941 cases diagnosed with chest radiography, the proportion of stage I lung cancers was respectively 50% and 31% in the two groups (1).

Lung cancer screening.

Lung cancer screening.

Estimating the Completeness of Lung Cancer Registry in Ardabil, Iran with a Three-Source Capture-Recapture Method.

Cancer registration is an important component of a comprehensive cancer control program, providing timely data and information for research and administrative use. Capture-recapture methods have been used as tools to investigate completeness of cancer registry data. This study aimed to estimate the completeness of lung cancer cases registered in Ardabil Population Based Cancer Registry (APBCR) with a three-source capture-recapture method. Data for all new cases of lung cancer reported by three sources (pathology reports, death certificates, and medical records) to APBCR for 2006 and 2008 were obtained. Duplicate cases shared among the three sources were identified based on similarity of first name, last name and father's names. A log-linear model was used to estimate number of missed cases and to control for dependency among sources. A total of 218 new cases of lung cancer was reported by three sources after removing duplicates. The estimated completeness calculated by log-linear method was 26.4 for 2006 and 27.1 for 2008. The completeness differed according to gender. In men, the completeness was 26.0% for 2006 and 28.1 for 2008. In women, the completeness was 36.5% for 2006 and 46.9 for 2008. In conclusion, none of the three sources can be considered as a reliable source for accurate cancer incidence estimation.

ATM protein is deficient in over 40% of lung adenocarcinomas

Lung cancer is the leading cause of cancer-related mortality in the USA and worldwide, and of the estimated 1.2 million new cases of lung cancer diagnosed every year, over 30% are lung adenocarcinomas. The backbone of 1st-line systemic therapy in the metastatic setting, in the absence of an actionable oncogenic driver, is platinum-based chemotherapy. ATM and ATR are DNA damage signaling kinases activated at DNA double-strand breaks (DSBs) and stalled and collapsed replication forks, respectively. ATM protein is lost in a number of cancer cell lines and ATR kinase inhibitors synergize with cisplatin to resolve xenograft models of ATM-deficient lung cancer. We therefore sought to determine the frequency of ATM loss in a tissue microarray (TMA) of lung adenocarcinoma. Here we report the validation of a commercial antibody (ab32420) for the identification of ATM by immunohistochemistry and estimate that 61 of 147 (41%, 95% CI 34%-50%) cases of lung adenocarcinoma are negative for ATM protein expression. As a positive control for ATM staining, nuclear ATM protein was identified in stroma and immune infiltrate in all evaluable cases. ATM loss in lung adenocarcinoma was not associated with overall survival. However, our preclinical findings in ATM-deficient cell lines suggest that ATM could be a predictive biomarker for synergy of an ATR kinase inhibitor with standard-of-care cisplatin. This could improve clinical outcome in 100,000's of patients with ATM-deficient lung adenocarcinoma every year.

Adjustment to Life with Lung Cancer.

In Poland, lung cancer is the most common type of cancer in males (20% of all cases) and third most common type of cancer in females (9% of all cases), right behind breast and colorectal cancers. Recently, 28,000 new cases of lung cancer per year were reported in both genders. The objective of the study was to asses coping strategies, pain management, acceptance of illness and adjustment to cancer in patients diagnosed with pulmonary carcinoma and the effect of socioeconomic variables on the abovementioned issues. The study included 243 patients diagnosed with lung cancer during outpatient chemotherapy (classical chemotherapy and molecularly targeted therapies) at the Center of Oncology, Maria Skłodowska-Curie Institute in Warszawa. We applied the Paper and Pencil Interview (PAPI) technique. The questionnaire interview was composed of demographic questions and the following four psychometric tests: BPCQ measuring the influence of factors affecting pain management in patients, CSQ designed to evaluate pain coping strategies, AIS questionnaire, measuring disease acceptance, and the mini-Mac scale, assessing psychological adjustment to disease. The highest mean score recorded in the BPCQ was recorded in the powerful doctors subscale (16.79) and the lowest in the internal factors section (15.64). Education, professional status and income were the variables which differentiated the scores. We recorded the top average score in CSQ in the coping self statements subscale (mean = 19.64), and the lowest score in the reinterpreting pain sensations subscale (mean score = 10.32). The results of the test were differentiated by education and income. Patients had the highest Mini-MAC scale scores in the fighting spirit section (21.91). In the case of patients affected with lung cancer, education and professional status affect the way patients treat doctors in the disease process. These variables are also critical in patients' approach to disease and methods of coping with it.

KRAS AND THE REALITY OF PERSONALIZED MEDICINE IN NON-SMALL CELL LUNG CANCER.

Lung cancer is the leading cause of mortality among all cancer types, worldwide. Latest available global statistics of World Health Organization report 1.59 million casualities in 2012 alone. Worldwide, 1 in 5 cancer deaths are caused by lung cancer. In 2016, in USA alone, estimated new cases of lung cancer are 224,390, of which 158,080 are expected to result in death as reported by National Cancer Institute. Non-small cell lung cancer (NSCLC), a histological subtype, comprises of about 85% of all cases, which is nearly 9 out of 10 lung cancer patients. Efforts are underway to develop and improve targeted therapy strategies. Certain mutations are being clinically targeted such as those in EGFR and ALK genes. However, one of the most frequently mutated genes in NSCLC is the KRAS oncogene, which is currently untargetable. Approximately 25% of all types of NSCLC tumors contain KRAS mutations, which remain as an undruggable challenge. These mutations are indicative of poor prognosis and confer negative response to standard chemotherapy. Furthermore, tumors harboring KRAS mutations are unlikely to respond to currently available targeted treatments such as Tyrosine Kinase Inhibitors. Therefore, there is a definitive, urgent need to generate new targeted therapy approaches for KRAS mutations. Current strategies have major limitations and evolve around targeting molecules upstream and downstream of KRAS. Direct targeting is not available in the clinic. Combination therapies of multiple agents are being sought. Concentrated efforts are needed to accelerate basic research and consecutive clinical trials to achieve effective targeting of KRAS.

The Use of the Health Disparities Calculator in Analysis of the Lung Cancer Burden in Urban and Rural Populations in the Świętokrzyskie Province (Poland): 1999–2010

Abstract The purpose of the study was a comparative analysis of the burden of lung cancer in urban and rural areas in the Świętokrzyskie Province in the years 1999–2010. The material for the study accounted for information about the number of new cases of lung cancer obtained from the Świętokrzyskie Cancer Registration Office in Kielce and data from the Central Statistical Office concerning the number of deaths due to lung cancer in the years 1999–2010. Crude and age-standardized incidence, mortality, and potential years of life lost rates were calculated separately for groups of men and women in urban and rural areas. A comparative analysis of coefficients in urban and rural areas based on Rate Ratio (RR) and Rate Difference (RD) was performed by using the Health Disparities Calculator. The average annual incidence of lung cancer among men was 18% lower in the urban population than in the rural, while the mortality rate was 16% lower. For women, the incidence and mortality rates were higher in urban areas as opposed to rural areas – by 48% and 54% respectively. The comparative analysis of the burden of lung cancer showed great diversity between urban and rural populations in the Świętokrzyskie Province.