Table 1.

Highlights of this article

  • Tobacco control activities since 1964 have resulted in decreasing lung cancer mortality in the United States.

  • Many carcinogens in tobacco products have been identified and the metabolic pathways leading to DNA adduct formation have been elucidated.

  • Multiple DNA adducts are present in the lungs of smokers consistent with the thousands of mutations found in critical genes in lung cancer.

  • Tobacco carcinogen and toxicant biomarkers provide an objective way to quantify dose, and possibly lung cancer risk, in smokers.

  • Screening with helical CT has been shown to reduce lung cancer mortality

  • Ongoing research is seeking to refine risk assessment models to focus screening resources to the highest risk populations

  • Although no agents are approved for lung cancer prevention, promising agents and new clinical trials models are currently being tested