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JAMA Patient Page
January 15, 2003

Lung Cancer

JAMA. 2003;289(3):380. doi:10.1001/jama.289.3.380

Of all the types of cancer, lung cancer is responsible for the most deaths in men and women. It is estimated that about 169,400 new cases of lung cancer and about 154,900 lung cancer deaths will have occurred in the United States in 2002.

Tobacco smoking is thought to be responsible for 8 out of 10 cases of lung cancer. Smoking greatly increases the risk of developing lung cancer because tobacco smoke contains carcinogens (substances that can cause cancer). Exposure to second-hand smoke from being around people who smoke also increases the risk of developing lung cancer.

An article in the January 15, 2003, issue of JAMA reports that a screening technique called helical computed tomography using computerized x-ray images is unlikely to be a cost-effective method for early detection of lung cancer in smokers. At this time, stopping smoking is the only proven method for reducing the risk of developing lung cancer.


  • Persistent cough

  • Constant chest pain

  • Fatigue

  • Loss of appetite or weight loss

  • Recurrent pneumonia

  • Swelling of neck and face

  • Coughing up blood


If lung cancer is suspected, your doctor may order a chest x-ray and a sputum test, in which mucus coughed up from the lungs is analyzed. To confirm the presence of lung cancer, a biopsy may be performed: a small sample of lung tissue is removed and examined for cancerous cells. If lung cancer is diagnosed, your doctor will want to determine the extent of the cancer and whether it has spread to other organs, a process known as staging. Knowing the stage of the disease is important in determining treatment.


Many factors go into determining the best treatment for lung cancer, including the stage of the disease, the specific type of cancer cells, the location in the lungs, and the general health of the patient.

  • Surgery to remove part of the lung, or in some cases an entire lung, may be performed. Surgery for some tumors may not be possible because of their size or location.

  • Chemotherapy (using drugs that kill cancer cells) is commonly used to treat cancer. Chemotherapy drugs are often given by vein.

  • Radiation therapy kills cancer cells by using high-energy rays supplied either by an external source aimed at the tumor or by implanting tiny radioactive particles directly in the tumor.

Chemotherapy and radiation therapy can have serious side effects, especially because these two treatments affect healthy as well as cancerous cells. Typical side effects include nausea, vomiting, hair loss, mouth sores, and fatigue.



To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at A Patient Page on tobacco use was published in the September 1, 1999, issue, and one on quitting smoking was published in the July 24/31, 2002, issue.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.