Hrönn Harðardóttir¹

Steinn Jónsson^1,2

Örvar Gunnarsson³

Bylgja Hilmarsdóttir⁴

Jurate Ásmundsson⁴

Ingibjörg Guðmundsdóttir⁴

Vaka Ýr Sævarsdóttir³

Sif Hansdóttir^1,2

Pétur Hannesson^1,5

Tómas Guðbjartsson^1,6

 

¹Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland, ²Faculty of Medicine, University of Iceland, Reykjavik, Iceland, ³Department of Oncology, Landspitali University Hospital, Reykjavik, Iceland, ⁴Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland, ⁵Department of Radiology, Landspitali University Hospital, Reykjavik, Iceland, ⁶Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.

Correspondence: Hrönn Harðardóttir, hronnh@landspitali.is

Key words: lung carcinoma, small cell, non-small cell, histology, diagnosis, staging, immunohistology, screening, treatment, surgery, chemotherapy, radiation therapy, outcome, review

Lung cancer is the second and third most common cancer in Iceland for females and males, respectively. Although the incidence is declining, lung cancer still has the highest mortality of all cancers in Iceland. Symptoms of lung cancer can be specific and localized to the lungs, but more commonly they are unspecific and result in significant diagnostic delay. Therefore, majority of lung cancer patients are diagnosed with non-localized disease. In recent years, major developments have been made in the diagnosis and treatment of lung cancer. Positive emission scanning (PET) and both transbroncial (EBUS) or transesophageal ultrasound (EUS) biopsy techniques have resulted in improved mediastinal staging of the disease and minimal invasive video-assisted thoracic surgery (VATS) has lowered postoperative complications and shortened hospital stay. Technical developments in radiotherapy have benefitted those patients who are not candidates for curative surgery. Finally, and most importantly, recent advances in targeted chemotherapeutics and development of immunomodulating agents have made individual tailoring of treatment possible. Recent screening-trials with low-dose computed tomography show promising results in lowering mortality. This evidence-based review focuses on the most important developments in the diagnosis and treatment of lung cancer, and includes Icelandic studies in the field.