drjanak
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Oncolocy - Lung Cancer
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07.14.08 (2 months ago)
#2
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Sabiston Textbook of Surgery, 18th ed. Ch 59- Lung > Lung Cancer
Etiology
Cigarette smoking is unequivocally the most important risk factor in the development of lung cancer. Smoking provides a 22-fold increased risk for lung cancer death in men and a 12% increased risk in women. Other environmental factors that may predispose to lung cancer include industrial substances such as asbestos, arsenic, chromium, or nickel; organic chemicals, radon, or iatrogenic radiation exposure; air pollution; and other environmental (secondary) smoke in nonsmokers.
Schwartz's Surgery 8th Ed > Part II. Specific Considerations > Chapter 18. Chest Wall, Lung, Mediastinum, and Pleura
Lung Neoplasms
Cigarette smoking is the primary cause of lung cancer. Two lung cancer cell types, squamous cell carcinoma and small cell carcinoma, are extraordinarily rare in the absence of cigarette smoking.
Other causes of lung cancer include exposure to a number of industrial compounds, including asbestos, arsenic, and chromium compounds. Of particular note is the ominous combination of asbestos exposure and cigarette smoking, which together have a multiplicative effect on risk, as opposed to an additive effect. Patients with chronic obstructive pulmonary disease (COPD) are at higher risk for lung cancer than would be predicted based on smoking risk alone. A previous history of tuberculosis with secondary scar formation also leads to a higher risk of primary lung carcinoma.
Over 3000 chemicals have been identified in tobacco smoke, but the main chemical carcinogens are polycyclic aromatic hydrocarbons. Once inhaled and absorbed, these compounds become mutagenic through their activation by specific enzymes, binding to macromolecules such as deoxyribonucleic acid (DNA), and then induction of mutations.
The term bronchial carcinoma is synonymous with lung cancer in general. Both terms refer to any epithelial carcinoma occurring in the bronchopulmonary tree.
Both textbooks blame cigarette smoking as the primary cause and Schwartz goes on to blame polycylic aromatic hydrocarbons as the main carcinogen in cigarette smoke.
I would go with hydrocarbons as the answer.
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