Is the shape of the decline in risk following quitting smoking similar for squamous cell carcinoma and adenocarcinoma of the lung? A quantitative review using the negative exponential model

Fry, John; P, Lee; Forey, Barbara; Coombs, Katharine J.

doi:10.1016/j.yrtph.2015.02.010

Cited by 7 publications

(5 citation statements)

References 41 publications

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“… 24 Besides, from view of actual pharmacologic effect, quitting smoking showed different effect among different cell type of pulmonary malignancy. 25 In our study, 55 current smokers were identified. A 75% belongs to adenocarcinoma patients and 25% belongs to nonadenocarcinoma patients.…”

Section: Discussionmentioning

confidence: 98%

Recurrence Risk Factors Analysis for Stage I Non-small Cell Lung Cancer

Yeh

et al. 2015

Medicine

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Lung cancer is the leading cause of cancer-related death worldwide. Even early-stage patients might encounter disease recurrence with relative high risk. Effective postoperative therapy is based on an accurate assessment of treatment failure after surgery. The aim of this study is to construct a disease-free survival (DFS) prediction model and stratify patients into different risk score groups.A total of 356 pathological stage I patients (7th American Joint Committee on Cancer) who underwent lung resection from January 2005 through June 2011 were retrospectively reviewed. Of these patients, 63 patients were eliminated for this study. A total of 293 p-stage I patients were included for further univariate and multivariate analysis. Clinical, surgical, and pathological factors associated with high risk of recurrence were analyzed, including age, gender, smoking status, additional primary malignancy (APM), operation method, histology, visceral pleural invasion, angiolymphatic invasion, tumor necrosis, and tumor size.Of the 293 p-stage I non-small cell lung cancer (NSCLC) patients examined, 143 were female and 150 were male, with a mean age of 62.8-years old (range: 25–83-years old). The 5-year DFS and overall survival rates after surgery were 58.9% and 75.3%, respectively. On multivariate analysis, current smoker (hazards ratio [HR]: 1.63), APM (HR: 1.86), tumor size (HR: 1.54, 2.03), nonanatomic resections (HR: 1.81), adenocarcinoma histology (HR: 2.07), visceral pleural invasion (HR: 1.54), and angiolymphatic invasion (HR: 1.53) were found to be associated with a higher risk of tumor recurrence. The final model showed a fair discrimination ability (C-statistic = 0.68). According to the difference risk group, we found patients with intermediate or higher risk group had a higher distal relapse tendency as compared with low risk group (P = 0.016, odds ratio: 3.31, 95% confidence interval: 1.21–9.03).Greater than 30% of disease recurrences occurred after surgery for stage I NSCLC patients. That is why we try to establish an effective DFS predicting model based on clinical, pathological, and surgical covariates. However, our initial results still need to be validated and refined into greater population for better application in clinical use.

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Section: Discussionmentioning

confidence: 98%

Recurrence Risk Factors Analysis for Stage I Non-small Cell Lung Cancer

Yeh

et al. 2015

Medicine

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“…In contrast, the majority of previous studies showed a clear negative association between smoking cessation and lung cancer. Evidence suggests that this association varies by histologic cell type [ 24 , 25 ]. An increased duration of smoking cessation has been linked to a decreased risk of small cell and squamous cell carcinoma but not with adenocarcinoma [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Evidence suggests that this association varies by histologic cell type [ 24 , 25 ]. An increased duration of smoking cessation has been linked to a decreased risk of small cell and squamous cell carcinoma but not with adenocarcinoma [ 24 , 25 ]. Apart from the role of histologic cell type in this association, the time that needs to pass before the risk of lung cancer among quitters reaches that of never smokers is less clear.…”

Section: Discussionmentioning

confidence: 99%

Lifetime Smoking History and Cause-Specific Mortality in a Cohort Study with 43 Years of Follow-Up

2016

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BackgroundIn general, smoking increases the risk of mortality. However, it is less clear how the relative risk varies by cause of death. The exact impact of changes in smoking habits throughout life on different mortality risks is less studied.MethodsWe studied the impact of baseline and lifetime smoking habits, and duration of smoking on the risk of all-cause mortality, mortality of cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), any cancer and of the four most common types of cancer (lung, colorectal, prostate, and breast cancer) in a cohort study (Vlagtwedde-Vlaardingen 1965–1990, with a follow-up on mortality status until 2009, n = 8,645). We used Cox regression models adjusted for age, BMI, sex, and place of residence. Since previous studies suggested a potential effect modification of sex, we additionally stratified by sex and tested for interactions. In addition, to determine which cause of death carried the highest risk we performed competing-risk analyses on mortality due to CVD, cancer, COPD and other causes.ResultsCurrent smoking (light, moderate, and heavy cigarette smoking) and lifetime persistent smoking were associated with an increased risk of all-cause, CVD, COPD, any cancer, and lung cancer mortality. Higher numbers of pack years at baseline were associated with an increased risk of all-cause, CVD, COPD, any cancer, lung, colorectal, and prostate cancer mortality. Males who were lifetime persistent pipe/cigar smokers had a higher risk of lung cancer [HR (95% CI) = 7.72 (1.72–34.75)] as well as all-cause and any cancer mortality. A longer duration of smoking was associated with a higher risk of COPD, any and lung cancer [HR (95% CI) = 1.06 (1.00–1.12), 1.03 (1.00–1.06) and 1.10 (1.03–1.17) respectively], but not with other mortality causes. The competing risk analyses showed that ex- and current smokers had a higher risk of cancer, CVD, and COPD mortality compared to all other mortality causes. In addition, heavy smokers had a higher risk for COPD mortality compared to cancer, and CVD mortality.ConclusionOur study indicates that lifetime numbers of cigarettes smoked and the duration of smoking have different impacts for different causes of mortality. Moreover, our findings emphasize the importance of smoking-related competing risks when studying the smoking-related cancer mortality in a general population and that smoking cessation immediately effectively reduces the risk of all-cause and any cancer mortality.

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“…RRs for ex-smokers were also substantially higher for squamous cell carcinoma (8.74, 95% CI 6.94-11.01) than for adenocarcinoma (2.85, 2.20-3.70). In a separate publication [58], based on data from 85 studies comparing cancer risks in current smokers, quitters (by time quit) and never smokers, it was found that the rate of decline in RR following quitting was somewhat less rapid for adenocarcinoma than for squamous cell carcinoma, where the half-lives were estimated, respectively, as 14.45 (11.92-17.45) and 11.68 (10.22-13.34). The slower decline in risk for adenocarcinoma was evident in subgroups by sex, age and other factors.…”

Section: Variation In Relative Risk Of Lung Cancer By Histological Typementioning

confidence: 99%

The Epidemiology of Tobacco and Lung Cancer: Some Conclusions from a Lifetime of Research

P¹

2017

A Global Scientific Vision - Prevention, Diagnosis, and Treatment of Lung Cancer

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This review summarizes evidence on the smoking/lung cancer relationship, based on the author's 50 years' experience. It starts by illustrating variations in national rates by time and sex. It then demonstrates that the relationship of smoking to overall lung cancer risk is strong, consistently seen and dose-related with amount smoked, duration, age of start and time of quitting. Relative risks vary markedly by country, but little by sex, age, race, occupation, genetics and other factors. Though precisely estimating the smoking risk is difficult, the relationship is clearly causal, not explained by bias or confounding. The risk from smoking is reduced in lower tar filter cigarettes, and essentially independent of mentholation and type of curing. Lung cancer risk is not increased by smokeless tobacco use. The relative risk is much greater for squamous/small-cell carcinoma than for adeno/ large-cell carcinoma. The argument that the increasing ratio of squamous to adenocarcinoma results from changes in cigarettes is shown to be weak, the increase also being seen in never smokers, starting before filters were introduced, and associated with diagnostic changes. Most of the weak association of lung cancer with passive smoking is explicable by confounding and by misclassification of some ever smokers as never smokers.

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Is the shape of the decline in risk following quitting smoking similar for squamous cell carcinoma and adenocarcinoma of the lung? A quantitative review using the negative exponential model

Cited by 7 publications

References 41 publications

Recurrence Risk Factors Analysis for Stage I Non-small Cell Lung Cancer

Recurrence Risk Factors Analysis for Stage I Non-small Cell Lung Cancer

Lifetime Smoking History and Cause-Specific Mortality in a Cohort Study with 43 Years of Follow-Up

The Epidemiology of Tobacco and Lung Cancer: Some Conclusions from a Lifetime of Research

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