Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

Recent Trends of Lung Cancer in Korea

  • Lee, Jae Guk (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Ho Cheol (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Chang-Min (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2020.11.17
  • Accepted : 2021.02.10
  • Published : 2021.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Lung cancer is one of the leading causes of cancer-related deaths in Korea. Although the smoking rate has decreased over time, the prevalence of lung cancer still remains high. In this study, we reviewed recent trends on the incidence, epidemiology, screening, diagnosis, and treatment of lung cancer in Korea by analyzing data from the national lung cancer registry and recently-published studies. Although approximately 40% of patients with non-small cell lung cancer (NSCLC) were diagnosed as stage IV, the 5-year relative survival rate improved from 11.3% (1993-1995) to 30.2% (2013-2017), possibly due to advances in methods of diagnosis and therapy. In addition, the 2019 implementation of the national lung cancer screening program with low-dose computed tomography may have also contributed to these improvements in survival rates. Recently, molecular diagnosis has become more widely used in the identification of genetic mutations in tissue specimens. Target therapy and immune checkpoint inhibitors have also been successfully used, particularly in cases of advanced NSCLC. In the future, further research on the optimal management of lung cancer remains necessary.

Keywords

References

  1. World Health Organization. Cancer Fact [Internet]. Geneva: World Health Organization; 2018 [cited 2019 Nov 1]. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer.
  2. Jung KW, Won YJ, Kong HJ, Lee ES. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2016. Cancer Res Treat 2019;51:417-30. https://doi.org/10.4143/crt.2019.138
  3. Kim Y. Evidence of national lung cancer screening program in Korea. Korean J Health Promot 2019;19:161-5. https://doi.org/10.15384/kjhp.2019.19.4.161
  4. Park HJ, Lee SH, Chang YS. Recent advances in diagnostic technologies in lung cancer. Korean J Intern Med 2020;35: 257-68. https://doi.org/10.3904/kjim.2020.030
  5. Jung CY, Antonia SJ. Tumor immunology and immune checkpoint inhibitors in non-small cell lung cancer. Tuberc Respir Dis 2018;81:29-41. https://doi.org/10.4046/trd.2017.0120
  6. National Cancer Information Center. Annual report of cancer statistics in Korea in 2017. Goyang: National Cancer Center; 2020.
  7. Shin A, Oh CM, Kim BW, Woo H, Won YJ, Lee JS. Lung cancer epidemiology in Korea. Cancer Res Treat 2017;49:616-26. https://doi.org/10.4143/crt.2016.178
  8. 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. https://doi.org/10.1016/j.lungcan.2014.01.009
  9. Janssen-Heijnen ML, Coebergh JW. The changing epidemiology of lung cancer in Europe. Lung Cancer 2003;41:245-58. https://doi.org/10.1016/S0169-5002(03)00230-7
  10. Devesa SS, Shaw GL, Blot WJ. Changing patterns of lung cancer incidence by histological type. Cancer Epidemiol Biomarkers Prev 1991;1:29-34.
  11. Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 2011;32:605-44. https://doi.org/10.1016/j.ccm.2011.09.001
  12. Park CK, Kim SJ. Trends and updated statistics of lung cancer in Korea. Tuberc Respir Dis 2019;82:175-7. https://doi.org/10.4046/trd.2019.0015
  13. Kim HC, Jung CY, Cho DG, Jeon JH, Lee JE, Ahn JS, et al. Clinical characteristics and prognostic factors of lung cancer in Korea: a pilot study of data from the Korean Nationwide Lung Cancer Registry. Tuberc Respir Dis 2019;82:118-25. https://doi.org/10.4046/trd.2017.0128
  14. Doll R. The epidemiology of cancer. Cancer 1980;45:2475-85. https://doi.org/10.1002/1097-0142(19800515)45:10<2475::AID-CNCR2820451004>3.0.CO;2-6
  15. National Lung Screening Trial Research Team; Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011;365:395-409. https://doi.org/10.1056/NEJMoa1102873
  16. Oudkerk M, Devaraj A, Vliegenthart R, Henzler T, Prosch H, Heussel CP, et al. European position statement on lung cancer screening. Lancet Oncol 2017;18:e754-66. https://doi.org/10.1016/S1470-2045(17)30861-6
  17. Forde PM, Ettinger DS. Targeted therapy for non-small-cell lung cancer: past, present and future. Expert Rev Anticancer Ther 2013;13:745-58. https://doi.org/10.1586/era.13.47
  18. Pinsky PF. Lung cancer screening with low-dose CT: a worldwide view. Transl Lung Cancer Res 2018;7:234-42. https://doi.org/10.21037/tlcr.2018.05.12
  19. Sampsonas F, Kakoullis L, Lykouras D, Karkoulias K, Spiropoulos K. EBUS: faster, cheaper and most effective in lung cancer staging. Int J Clin Pract 2018;72:ee13053.
  20. Tamiya M, Okamoto N, Sasada S, Shiroyama T, Morishita N, Suzuki H, et al. Diagnostic yield of combined bronchoscopy and endobronchial ultrasonography, under LungPoint guidance for small peripheral pulmonary lesions. Respirology 2013;18:834-9. https://doi.org/10.1111/resp.12095
  21. Gildea TR, Mazzone PJ, Karnak D, Meziane M, Mehta AC. Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med 2006;174:982-9. https://doi.org/10.1164/rccm.200603-344OC
  22. Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest 2007;131:1800-5. https://doi.org/10.1378/chest.06-3016
  23. Wu Z, Yang Z, Dai Y, Zhu Q, Chen LA. Update on liquid biopsy in clinical management of non-small cell lung cancer. Onco Targets Ther 2019;12:5097-109. https://doi.org/10.2147/OTT.S203070
  24. Suda K, Mitsudomi T. Racial differences in lung cancer genetics. J Thorac Oncol 2015;10:230-1. https://doi.org/10.1097/JTO.0000000000000439
  25. Yatabe Y, Kerr KM, Utomo A, Rajadurai P, Tran VK, Du X, et al. EGFR mutation testing practices within the Asia Pacific region: results of a multicenter diagnostic survey. J Thorac Oncol 2015;10:438-45. https://doi.org/10.1097/JTO.0000000000000422
  26. Choi CM, Kim HC, Jung CY, Cho DG, Jeon JH, Lee JE, et al. Report of the Korean Association of Lung Cancer Registry (KALC-R), 2014. Cancer Res Treat 2019;51:1400-10. https://doi.org/10.4143/crt.2018.704
  27. Park JY, Jang SH, Kim HJ, Park YB, Kwon JH, Song HH, et al. Predicting the treatment response using a direct sequencing method for EGFR in non-squamous, non-small cell lung cancer. Korean J Med 2011;81:611-22.
  28. Lee HJ, Xu X, Kim H, Jin Y, Sun P, Kim JE, et al. Comparison of direct sequencing, PNA clamping-real time polymerase chain reaction, and pyrosequencing methods for the detection of EGFR mutations in non-small cell lung carcinoma and the correlation with clinical responses to EGFR tyrosine kinase inhibitor treatment. Korean J Pathol 2013;47:52-60. https://doi.org/10.4132/KoreanJPathol.2013.47.1.52
  29. Ministry of Health and Welfare. Notice 2017-19. Partial revision to details on criteria and method of application for medical care benefits [Internet]. Sejong: Ministry of Health and Welfare; 2017 [cited 2020 Feb 25]. Available from: http://www.mohw.go.kr/react/jb/sjb0406vw.jsp.
  30. Kim JS, Kang EJ. Targeted therapy for non-small cell lung cancer. Korean J Med 2020;95:78-88. https://doi.org/10.3904/kjm.2020.95.2.78
  31. Min KW, Kim WS, Jang SJ, Choi YD, Chang S, Jung SH, et al. Comparison of EGFR mutation detection between the tissue and cytology using direct sequencing, pyrosequencing and peptide nucleic acid clamping in lung adenocarcinoma: Korean multicentre study. QJM 2016;109:167-73. https://doi.org/10.1093/qjmed/hcv103
  32. Mok TS, Wu YL, Ahn MJ, Garassino MC, Kim HR, Ramalingam SS, et al. Osimertinib or platinum-pemetrexed in EGFR T790M-positive lung cancer. N Engl J Med 2017;376:629-40. https://doi.org/10.1056/NEJMoa1612674
  33. Park JY, Jang SH. Epidemiology of lung cancer in Korea: recent trends. Tuberc Respir Dis 2016;79:58-69. https://doi.org/10.4046/trd.2016.79.2.58
  34. Arbour KC, Riely GJ. Systemic therapy for locally advanced and metastatic non-small cell lung cancer: a review. JAMA 2019;322:764-74. https://doi.org/10.1001/jama.2019.11058
  35. Kim HC, Choi CM. Current status of immunotherapy for lung cancer and future perspectives. Tuberc Respir Dis 2020;83:14-9. https://doi.org/10.4046/trd.2019.0039