title: The silent epidemic: tobacco and the evolution of lung cancer and its treatment.
abstract: Considered a rare disease during the 19th century, lung cancer became the most virulent and lethal cause of cancer mortality by the end of the 20th century. In this paper, lung cancer and its treatment are addressed within the social, cultural, economic, and political context of the last century. Because lung cancer is related to the consumption of cigarettes, the battles over tobacco control are highlighted. Four time periods are addressed: the early years (1900-1930), beginning of the epidemic (1930-1960), defining the problem (1960-1980), and expanding options (1980-1990s). Although improvements have been made in science and technology, attempts at finding curative treatments have met with little success. Smoking cessation and efforts to control tobacco (especially among children and adolescents) remain the most important factors if the incidence of lung cancer is to be curtailed in the future. Providing care to individuals with the illness is a current challenge. Research examining the efficacy of treatments and their effect on survival, health-related quality of life, and cost outcomes is essential and can be best achieved through the efforts of multidisciplinary teams.
authors.affiliation: Smoking Cessation Research Program, Harvard Medical School/Harvard School of Dental Medicine, Oral Health Policy and Epidemiology, Boston, Massachusetts, USA. cooleymary@aol.com
authors.forename: M E
authors.initials: ME
authors.lastname: Cooley
authors.forename: L R
authors.initials: LR
authors.lastname: Kaiser
authors.forename: J L
authors.initials: JL
authors.lastname: Abrahm
authors.forename: E
authors.initials: E
authors.lastname: Giarelli
mesh_terms: D017281:Cost of Illness; D004196:Disease Outbreaks / Q000266:history*; D006291:Health Policy / Q000266:history; D049673:History, 20th Century; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000266:history*; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects / Q000266:history* / Q000331:legislation & jurisprudence; D016540:Smoking Cessation / Q000266:history; D012924:Social Conditions; D019460:Tobacco Industry / Q000266:history* / Q000331:legislation & jurisprudence; D014481:United States / Q000453:epidemiology