Lessons and opportunities from improved understanding of global lung cancer histological subtypes

In a population-based study of variations in lung cancer incidence by histological subtype in 2020, Yanting Zhang and colleagues 1 Zhang Y Vaccarella S Morgan E et al. Global variations in lung cancer incidence by histological subtype in 2020: a population-based study. Lancet Oncol. 2023; (published online Oct 11.)https://doi.org/10.1016/S1470-2045(23)00444-8 Summary Full Text Full Text PDF Scopus (1) Google Scholar have provided, for the first time to my knowledge, data on a global scale, highlighting substantial geographical and sex-based differences. Although there are over 30 different primary lung malignancies, the four most common are adenocarcinoma, squamous cell carcinoma, large-cell carcinoma, and small-cell carcinoma, which account for most cases. 2 WHO Classification of Tumours Editorial BoardThoracic tumours. International Agency for Research on Cancer, Lyon2021 Google Scholar The different histological subtypes have different pathogeneses, prognoses, and treatment approaches, reinforcing the importance of an accurate diagnosis. 2 WHO Classification of Tumours Editorial BoardThoracic tumours. International Agency for Research on Cancer, Lyon2021 Google Scholar Zhang and colleagues report a worldwide trend of increasing adenocarcinoma incidence relative to squamous cell carcinoma, with adenocarcinoma being the most common type of lung cancer in all 185 countries in women and in 150 (81%) of 185 countries in men in 2020, supporting findings from previous smaller studies, 3 Lortet-Tieulent J Soerjomataram I Ferlay J Rutherford M Weiderpass E Bray F International trends in lung cancer incidence by histological subtype: adenocarcinoma stabilizing in men but still increasing in women. Lung Cancer. 2014; 84: 13-22 Summary Full Text Full Text PDF PubMed Scopus (288) Google Scholar , 4 Houston KA Mitchell KA King J White A Ryan BM Histologic lung cancer incidence rates and trends vary by race/ethnicity and residential county. J Thorac Oncol. 2018; 13: 497-509 Summary Full Text Full Text PDF PubMed Scopus (43) Google Scholar and these findings should not be ignored. Global variations in lung cancer incidence by histological subtype in 2020: a population-based studyAdenocarcinoma has become the most common subtype of lung cancer globally in 2020, with incidence rates in males exceeding those of squamous cell carcinoma in most countries, and in females in all countries. Our findings provide new insights into the nature of the global lung cancer burden and facilitates tailored national preventive actions within each world region. Full-Text PDF