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Lung carcinoma in African Americans

Nature Clinical Practice Oncology volume 4, pages 118–129 (2007)Cite this article

Abstract

Lung carcinoma is the most commonly diagnosed cancer and the leading cause of cancer deaths in the US. It accounts for 12% of all cancers diagnosed worldwide, making it the most common malignancy, other than nonmelanoma skin cancer. A new focus has emerged involving the role of race and ethnicity in lung carcinoma. Current health statistics data demonstrate striking disparities, which are most evident between African American patients and their white counterparts. This disparity is greatest among male patients, where statistically significant differences are seen not only in lung cancer incidence and risk, but also in survival and treatment outcomes. Several hypotheses that attempt to explain this disparity include genetic, cultural and socioeconomic differences, in addition to differences in tobacco use and exposure. Current evidence does not clearly identify the reasons for this observed disparity, or the role the aforementioned factors play in the development and overall outcomes of people with lung cancer in these populations. This disease continues to pose a considerable public health burden and more research is needed to improve understanding of the disparity of lung carcinoma statistics among African Americans. This review summarizes the existing body of knowledge regarding lung carcinoma in African Americans and attempts to identify promising areas for future investigation and intervention.

Key Points

  • US health statistics indicate a racial disparity of lung carcinoma in terms of risks, management, and outcomes, which is most striking in African Americans compared with their white counterparts

  • Several hypotheses have been put forward to explain the disparity between ethnic groups, including differences in tobacco exposure, genetic susceptibility, culture, and socioeconomics, but no single factor has been able to account for it

  • This disparity has led to increased mortality and lower survival rates in African Americans compared with their white counterparts

  • Despite a lack of clear evidence that genetic and proteomic alterations have any significant role in lung carcinoma in African Americans, evidence exists that race-specific gene mutations in EGFR are associated with improved responses to therapy

  • Most investigations and interventions have focused on strategies to improve health care access and use, but more studies are needed to understand the genetic polymorphisms in African Americans that influence risk, susceptibility to exposure, and treatment outcomes in lung carcinoma

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Figure 1: Age-adjusted lung carcinomo incidence rates for African Americans and whites.
Figure 2: Lung cancer risk by age group for African Americans and whites.
Figure 3: Relative survival of African Americans and whites diagnosed with lung cancer.
Figure 4: Age-adjusted total US mortality rates for African Americans and whites from 1994–2003, US standard population.
Figure 5: Age-adjusted prevalence of smoking among African Americans and whites aged 18 years and over from January 2005 to June 2005.
Figure 6: Overview of carcinogenesis and genetic polymorphism in lung cancer.
Figure 7: Schematic diagram showing the structure of the EGFR gene and the structural protein domains it encodes.

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Acknowledgements

R Salgia is supported by NIH/National Cancer Institute – R01 award (R01 CA100750-01A1), Mesothelioma Applied Research Foundation (MARF), American Cancer Society Award (National), and Institutional Cancer Research Awards from the University of Chicago Cancer Center with the American Cancer Society and the V-Foundation.

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Authors and Affiliations

  1. Department of Medicine, Department of Surgery, O Abidoye is a clinical fellow in Hematology and Oncology, and R Salgia is Associate Professor and Director, both in the Section of Hematology/Oncology, and MK Ferguson is a professor in the Section of Cardiothoracic Surgery, University of Chicago Medical Center, Chicago IL, USA.,

    Oyewale Abidoye, Mark K Ferguson & Ravi Salgia

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  1. Oyewale Abidoye
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Correspondence to Ravi Salgia.

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Abidoye, O., Ferguson, M. & Salgia, R. Lung carcinoma in African Americans. Nat Rev Clin Oncol 4, 118–129 (2007). https://doi.org/10.1038/ncponc0718

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