2018 Volume 58 Issue 5 Pages 331-337
Lung cancer is the leading cause of death in both men and women worldwide, and the 5-year survival rate for advanced lung cancer is as low as 20%. The development of molecular-targeted cancer therapy has significantly improved the outcomes of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) fusion oncogenes. In addition, immune checkpoint inhibitors have also dramatically changed the treatment regimens of NSCLC. From the viewpoint of cancer prevention, the prevalence of lung cancer in men is expected to decrease in the future due to smoking cessation efforts. As the smoking prevalence in women is already lower than that in men, the incidence of lung cancer in women is not expected to decrease quite as much as that in men. However, the therapeutic effect of immune checkpoint inhibitors in smokers with NSCLC can be expected, while such an effect in never-smokers with NSCLC is not expected. Because smoking is linked to the expression of neo-antigens and increased numbers of somatic mutations, immune checkpoint inhibitors in NSCLC have suggested the smoking history to be associated with improved survival outcomes. Therefore, the importance of determining the susceptibility to lung cancer in never-smokers, especially among women, is expected to increase in the future. In this review, the author describes the risk factors of susceptibility to lung cancer that have been identified thus far and the prospects for the future of cancer prevention.
