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This is an old revision of this page, as edited by 200.120.73.176 (talk) at 12:34, 23 February 2014 (→Technical terms). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

	Lung cancer is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Misplaced Pages community. Even so, if you can update or improve it, please do so.
	This article appeared on Misplaced Pages's Main Page as Today's featured article on November 18, 2007.
Article milestones Date Process Result June 22, 2007 Good article nominee Listed August 10, 2007 Peer review Reviewed September 29, 2007 Featured article candidate Promoted
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This article is written in American English, which has its own spelling conventions (color, defense, traveled) and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus.

Archives

Archive 1 (2004–2008, includes GA review) Archive 2 (2008-Nov 2011) Archive 3 (Dec 2011–Present)

"Rate" vs. "Incidence"

In "Diagnosis", subsection "Classification", in the table the word "incidence" has been changed to "rate". I am unhappy about this. "Incidence" has a distinct epidemiological meaning while "rate" is vague. Even though "incidence" is stated in the table's main heading, given that values are quoted, I believe that "incidence" should also be used in the secondary heading. Axl ¤ 10:10, 10 June 2013 (UTC)

I sort of consider rate and incidence to be more or less the same with rate per 100,000 being more understandable. Have switched it back per your preference. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:14, 10 June 2013 (UTC)

Thank you for changing the table heading. I note that you say "rate and incidence more or less the same with rate per 100,000 being more understandable." It is precisely this sort of interpretation that leads to confusion with prevalence. Axl ¤ 20:25, 10 June 2013 (UTC)

One is per year and the other is not. I added the per year bit. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:28, 10 June 2013 (UTC)

No! Incidence is the number of new cases per unit population per unit time. Prevalence is the number of current cases per unit population at a given moment in time. Axl ¤ 09:04, 11 June 2013 (UTC

Yes so should we change it to "New cases per 100,000 per year"? Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:16, 11 June 2013 (UTC)

I'm not keen on doing that, but it would be accurate and unambiguous. Axl ¤ 12:24, 11 June 2013 (UTC)

Out of date information

I came here looking for surivival rates, and found a 5 year survival rate of 10%, cited to an article from 2007. This contrasts with http://www.medicinenet.com/lung_cancer/page7.htm#what_is_the_prognosis_outcome_of_lung_cancer which gives a 5 year survival rate of 17%, along with more details of types and stages and their survival rates. I don't know the reliability of that site, which fails to cite its own sources - but its article is labelled as last reviewed on 12/3/2013, so I strongly suspect it is in fact reliable, but things have improved in the past 6 years. My wikipedia mentor has told me not to touch anything medical; apparantly the owning projects have unique standards for reliable sources, and have been known to ban people for using unapproved ones. So I'm commenting here - how about at least putting accurate dates on potentially out of date information - or better yet, updating the information based on more recent sources - rather than giving out-dated and frightening information to readers whose interest in some medical issue stems from someone's recent diagnosis. Kobnach (talk) 19:21, 7 December 2013 (UTC)

Were does our article say the overall 5 year survival is 10%? Are you sure you are looking at the most recent version of the article? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:37, 7 December 2013 (UTC)

Yes medicinenet is not a great source. Globally what is the 5 year survival? This ref says 15% but it is probably for aggressively treated disease in the wealthy parts of the world. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:33, 7 December 2013 (UTC)

Yes this ref says 15% in the USA and worse in the developing world . Will update. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:33, 7 December 2013 (UTC)

Where did the article say 10%? Axl ¤ 22:36, 7 December 2013 (UTC)

It might have years ago. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:31, 8 December 2013 (UTC)

Screening

In screening section, it is not mentions anything about tumor marker. Use CT Scan and MRI is expensive and same with tumor marker, it are not diagnosis test, the tumor/cancer should be diagnosed by biopsy. Today, M2-PK cheap tumor marker is very usefull because of high sensitivity compare to use expensive and invasive colonoscopy. The tumor marker tests will be developed further in line with the time.

I propose to add article as below:

According to http://www.aacc.org/SiteCollectionDocuments/NACB/LMPG/tumor/chp3p_lung.pdf CYFRA 21.1 can aid in diagnosis especially when biopsy cannot to be done and CYFRA 21.1 is the most sensitive tumor marker for NSCLC. Together with CEA, CYFRA 21.1 will give more sensitivity. While NSE and ProGRP has more specificity of SCLC when is compared to CEA and CYFRA 21.1. ProGRP is more sensitive than NSE. However, the National Academy of Clinical Biochemistry says that for lung cancer screening purposes uses a single tumor marker only is not recommended. The tumor markers are also useful for monitoring, before and post therapy follow up.Gsarwa (talk) 13:49, 29 December 2013 (UTC)

USPSTF screening guidance

Published doi:10.7326/M13-2771 JFW | T@lk 07:47, 31 December 2013 (UTC)

Risk with fruit and vegetables

There has been a lot of editing of the fruit & veg part of the "Prevention" section recently. The reference (Key) states: "Many observational studies have found that lung cancer patients report a somewhat lower intake of fruits and vegetables than controls, but the effect of smoking is so large, compared with the small association with diet, that residual confounding by smoking is likely, and recent large prospective analyses with detailed adjustment for smoking have not shown a convincing association between fruit and vegetable intake and the risk for lung cancer." This certainly does not imply "unidentified lifestyle factors" as currently stated in the article. Axl ¤ 19:02, 30 January 2014 (UTC)

Yes feel free to fix. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:17, 30 January 2014 (UTC)

I have changed the text to mention only "confounding". Interested readers can read the reference. Axl ¤ 22:34, 15 February 2014 (UTC)

Many of our readers will not know what "confounding" is. We should at least describe it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:50, 15 February 2014 (UTC)

I have expanded on the statement. Axl ¤ 00:55, 17 February 2014 (UTC)

How about mentioning the Finnish study that showed excess consumption of vitamins etc. such as ß-carotene and vitamin A decreased survival in lung cancer? I think its been reviewed multiple times.CFCF (talk · contribs · email) 21:00, 21 February 2014 (UTC)

Saw some mention, but maybe more is due, will look up some articles. CFCF (talk · contribs · email) 21:02, 21 February 2014 (UTC)

Pulmonary tumors

"Lung cancer" designates only "Malignant tumors of the lung". It would be interesting tocreate a page "Pulmonary tumors", including benign tumors and malignant tumors. patho (talk) 10:14, 9 February 2014 (UTC)

Technical terms

Typically we list both lay and technical terms in the first sentence of the lead. Thus restored carcinoma of the lung . What are peoples thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:33, 20 February 2014 (UTC)

• Looking at various other cancer articles, I do not see any clear pattern of giving a technical term in the first sentence of the lead. See for example Brain tumour, Skin_cancer, liver cancer, stomach cancer, kidney cancer.
• Google ngrams tells me that the term "lung cancer" is about 10-15 times more common in general literature than "carcinoma of the lung", and google scholar and pubmed return similar proportions in the scientific and medical literature.
• The article itself states that not all lung cancers are carcinomas.

In conclusion I cannot see a good reason for the term "carcinoma of the lung" to be presented in the lead as if it is an equivalent term in similar use to "lung cancer". 200.120.73.176 (talk) 23:36, 20 February 2014 (UTC)

Lung cancer as a term, while common, is pretty generic and could be applied to mediastinal and wall neoplasms (lymphomas or sarcomas) that are not carcinoma. This article, deals exclusively with carcinoma of the lung. It also applies to every histopathologic diagnosis named in the article, "xxxx cell caricinoma of the lung". It's also in many article in pubmed (although lung cancer is more common). I think it's a more precise definition of what this article discusses. I'd leave it in. Ian Furst (talk) 00:12, 21 February 2014 (UTC)

Yes carcinoma of the lung and lung cancer are not exact synonyms if we are being exact. This came up in another cancer article a while ago. Can't remember what consensus was or which article, sorry. Lesion (talk) 00:18, 21 February 2014 (UTC)

If the article is not about lung cancer but specifically about carcinoma of the lung, then its title should be changed. 200.120.73.176 (talk) 02:38, 21 February 2014 (UTC)

I don't think that a name change is good. The main meaning of lung cancer is carcinoma of the lung, and this is the commonest term (even among professionals) for carcinoma of the lung. The most precise term is used when it is necessary to be precise, but reviews like this one may not mention the word carcinoma at all.

That said, I think that the other types of neoplastic lung conditions ought to be mentioned here, either as points of comparison (e.g., this type is far more common than that type, this class does not include those types) and/or with brief mentions to WP:Build the web and help place the carcinomas in context. WhatamIdoing (talk) 03:13, 21 February 2014 (UTC)

(←) I don't think removing the more technical term makes much sense. On many pages we list all the names for conditions (e.g. hepatic encephalopathy has four names for the same condition) and this is to make the terminology accessible to the reader rather than befuddle them. As for carcinoma vs cancer, this distinction is clarified later in the article. "Lung cancer" without a modifier is always carcinoma, because other lung tumours will immediately be labelled more specifically (e.g. carcinoid). JFW | T@lk 08:02, 21 February 2014 (UTC)

I don't think that a name change would be good either. I think that an article about lung cancer should discuss all the types of lung cancer, even if one particular subset accounts for the vast majority of cases. I just don't think there's much point in forcing in an "also known as" for a term which is infrequently used in both popular and medical usage, and is not even a direct synonym for the article's title. It's mentioned in both the lead section and in the body of the article that most but not all lung cancers are carcinomas, and this makes it clearly incorrect to say that "lung cancer is also known as carcinoma of the lung". 200.120.73.176 (talk) 10:21, 21 February 2014 (UTC)

• I remember this happened on Talk:Penile_cancer#Requested_move. The page used to be called "carcinoma of the penis", but it was decided to rename it to "Penile cancer" and widen the scope to include mention of sarcomas etc. Similar situation, almost all of these were carcinomas. Agree with WAID that should mention other types of malignancy that occur in the lungs, even if just to say they are rare. As to mention of "carcinoma of the lung" in parentheses in the lead, I have no particular opinion on this. Lesion (talk) 11:44, 21 February 2014 (UTC)

• Misplaced Pages:MEDMOS addresses this, though perhaps it needs to be made clearer.LeadSongDog come howl! 13:58, 21 February 2014 (UTC)

" Lung cancer as a term, while common, is pretty generic and could be applied to mediastinal and wall neoplasms (lymphomas or sarcomas) that are not carcinoma. "

— Ian Furst

While it "could" be applied, I am not sure that it ever is. The medical profession would certainly never refer to mediastinal lymphomas as "lung cancer". Histologically proven chest wall sarcomas would only ever be referred to by their histological status: "sarcoma", and never as "lung cancer". There are enough non-malignant nodules (hamartomas, etc.) that we never categorically describe an unknown nodule as "lung cancer". If pressed, we might say that lung cancer is a possibility.

In summary, the medical profession only ever uses the phrase "lung cancer" to mean "lung carcinoma".

The article currently includes the statement "The vast majority of lung cancers are carcinomas—malignancies that arise from epithelial cells." I am not sure if I added the statement. In any case, I think that this is sufficient to imply the few parenchymal sarcomas, etc., that arise within the lungs. I am happy to leave the statement "also known as carcinoma of the lung" in the opening sentence. Axl ¤ 14:30, 21 February 2014 (UTC)

How about neuroendocrine tumors of the lung? Normally these aren't referred to as carcinomas, but rather as carcinoid. I'm not sure I share JFW's sentiment that a patient would always know the difference between this an "regular" lung cancer. CFCF (talk · contribs · email) 20:52, 21 February 2014 (UTC)

Upon inspection there are two articles:

Pulmonary carcinoid tumour

Typical pulmonary carcinoid tumour

None of which are of any particular standard (the typical article doesn't even mention that it is a neuroendocrine tumor), but I know pathologists where I come from will call these cancers lung cancer at least when talking to or informing patients. This complicates the mention in the first sentence in my opinion. Maybe a mention of both is in order? Might look into fleshing out the mention of carcinoid/neuroendocrine tumors in this article myself, at least adding a sentence or two. CFCF (talk · contribs · email) 21:09, 21 February 2014 (UTC)

Hey Axl - I should have clarified. What I'd meant is that a layperson might refer to other thoracic/mediastinal tumors as "lung cancer", not realizing the distinction. I thought leaving the technical term in the first sentence might be helpful in this regard. Ian Furst (talk) 00:49, 22 February 2014 (UTC)

" I'm not sure I share JFW's sentiment that a patient would always know the difference between this an "regular" lung cancer. "

— CFCF

JFW does not assert that a patient would always know the difference. JFW states: " "Lung cancer" without a modifier is always carcinoma, because other lung tumours will immediately be labelled more specifically (e.g. carcinoid). " I agree with JFW's statement. Axl ¤ 02:29, 22 February 2014 (UTC)

" I know pathologists where I come from will call these cancers lung cancer at least when talking to or informing patients. "

— CFCF

That's a first for me. I have never heard of pathologists talking to patients. Axl ¤ 02:31, 22 February 2014 (UTC)

(Well to be frank, it depends on definition here; cytologists do, cytology being considered a sub-speciality here, but lets not get into that). On the other hand Robbins Pathology of disease differentiates between Lung cancer (which is carcinoma) and Lung tumors, which include the lot. Maybe a disambiguation page?CFCF (talk · contribs · email) 08:54, 22 February 2014 (UTC)

You're saying that cytologists inform patients that they have lung cancer? With respect, I don't believe you. Axl ¤ 12:49, 22 February 2014 (UTC)

I've only seen a pathologist called out to a clinic once. Sometimes they might do fine-needle aspiration cytology. Rarely they may be present in theatre (e.g. Moh's micrographic surgery although I've never seen this, but then the patient is unconscious).

To clarify and move the discussion forwards, I think the argument is that laypersons would call any cancer occurring in the lungs "lung cancer". Lesion (talk) 13:04, 22 February 2014 (UTC)

Well it seem things are done slightly differently in Sweden, there are consultations with cytologists, where the patient visits the clinic for any number of punctions, some of which where a cytologist may inform the patient of possible diseases before analyzing the sample, or upon follow-up. Fine needle aspiration is the least invasive, and may be done when a cytologist is called out to another clinic (simply bringing the set along), but for larger liver, kidney, breast biopsies etc., which do not require invasive surgery but require more kit are performed at the cytology clinic as long as the patient isn't bed-ridden. (Swedish)

Now to get the my suggestion, what about mentioning in the lead that there are other cancers, and linking to for example a lung tumor disambiguation page? CFCF (talk · contribs · email) 13:50, 22 February 2014 (UTC)

PathoWhat do you think? CFCF (talk · contribs · email) 14:03, 22 February 2014 (UTC)

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