Lung Carcinoma Surveillance Counterpoint: Canada

There were approximately 23,900 new cases of lung cancer in Canada in 2008 and 20,200 deaths [1]. Between 1995 and 2004, age-standardized incidence and mortality rates decreased for men but have increased for women (Table 7.1) [2]. Non-small cell histology makes up over 80 % of lung cancer and the remainder is largely small cell lung cancer (SCLC), a disease which typically spreads early and is treated using nonsurgical approaches [3]. Patients with stage I or II and highly selected patients with stage III. A non-small cell lung cancer (NSCLC) are potential candidates for resection [3]. Only about 12 % of patients have stage I disease and 6 % have stage II. Approximately 30 % of patients present with locally advanced disease and are not candidates for curative resection. However, a subset of these patients with good performance status, minimal or no weight loss, and nonbulky disease are candidates for combined modality therapy consisting of chemotherapy and radical radiation administered with curative intent.