Lung cancer: past, present, and future.

The epidemiology of lung cancer in industrialized nations during the 20th century is a fascinating phenomenon. It is predicted that 161,000 new cases of lung cancer will be diagnosed in the United States in 1991. Lung cancer will cause 143,000 deaths in the United States in 1991, and it has surpassed breast cancer as the leading cause of cancer-related deaths in women. The 5-year survival for patients with lung cancer has not changed significantly over the past several decades and is approximately 13%. The current attack on lung cancer is aimed at earlier detection, better understanding of its biology, or effective therapy, and prevention, the last of which is the key to controlling this disease. Medical historians of the future will surely be both amused by and disappointed in our efforts of the past five decades. Despite our knowledge of the most important causative factor in the development of lung cancer, our efforts to control this deadly epidemic have been paltry at best.