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Lung Cancer Risk Varies
Dramatically Among Smokers
Excerpt by
Jennifer Thomas, HealthScoutNews
If you're a smoker -- or
an ex-smoker -- the fear of lung cancer probably lurks somewhere
in the back of your mind.
But have you ever wondered how
likely you are to actually develop the deadly disease?
New research shows that even among
long-term, heavy smokers, the risk of getting lung cancer can
vary dramatically -- from less than 1 percent to a whopping 15
percent.
The risk of getting lung cancer
was most heavily influenced by age, duration of smoking and how
much a person smoked, says Dr. Peter Bach, lead author of the
study and an epidemiologist and pulmonary physician at Memorial
Sloan-Kettering Cancer Center in New York City.
"Before this study, anyone
who smoked for 25 or 30 years thought that they were at extra
high risk of lung cancer when, in fact, there is lots of difference
in risk," Bach says.
For individual smokers, this study
may either be very good news or very troubling news.
Consider: A 51-year-old woman who
smoked a pack a day for 28 years and then quit has only a 0.8
percent chance of getting lung cancer in the next decade, the
study found.
Compare her to a 68-year-old man
who has smoked two packs a day for 50 years and refuses to stop
smoking. If he keeps puffing away, his risk of getting lung cancer
in the next decade is 15 percent.
The study appears in the March
19 issue of the Journal of the National Cancer Institute.
Bach and his colleagues undertook
the study in part because of the increasing interest in using
low-dose helical computed tomography scans, commonly called CT
scans, to detect lung cancer in its early stages.
The problem with CT scans is that
the test often detects lung abnormalities that aren't lung cancer,
including infections and scarring. This can lead to unnecessary
biopsies and needless anxiety, he says.
"We thought it would be very
important for people to know if they're at the high end or the
low end of the risk scale," he says. "That way, they
can make a decision with their physician about whether or not
these CT scans are for them."
Bach and his colleagues used previous
data on more than 14,254 men and women aged 50 to 59 who were
considered heavy smokers, which was defined as having smoked a
pack a day for at least 20 years. The participants were either
current smokers or had stopped smoking within six years before
enrolling in the study. Another 4,000 participants were men aged
45 to 69 who had been exposed to asbestos, a risk factor of lung
cancer, and who were current or former smokers.
Study participants were followed
for 10 to 20 years. During the follow-up, about 1,110 people were
diagnosed with lung cancer.
Bach and his colleagues used the
data to create a mathematical model to calculate who is most likely
to get lung cancer.
Researchers then applied the model
to a sample of 300 people who had undergone cancer screening at
the Mayo Clinic and came up with these sample profiles:
- A 51-year-old woman who smoked
a pack a day for 28 years and then quit has only a 0.8 percent
chance of getting lung cancer in the next decade.
- A 52-year-old woman who smoked
a pack a day for 35 years and who continues to smoke has a 2.8
percent chance of getting lung cancer in the next decade.
- A 58-year-old man who smoked
25 cigarettes a day for 40 years but quit three years ago had
a 4.1 percent chance of getting lung cancer in the next decade.
- A 56-year-old woman who smoked
two packs a day for 44 years and continued to smoke had a 8.4
percent chance of getting lung cancer in the next decade.
- A 68-year-old man who smoked
two packs a day for 50 years and refused to stop smoking had
a 15 percent chance of getting lung cancer in the next decade.
His risk would drop to 10.8 percent if he quit.
"At the high end, you're talking
about one in seven people," he says.
Lung cancer is the leading cancer
killer of both men and women, according to the American Lung Association.
There were an estimated 164,100 new cases of lung cancer and an
estimated 156,900 deaths from the disease in the United States
in 2000.
Even if your risk of getting lung
cancer is relatively low, the study should not be read as permission
to keep puffing away, says Dr. Jay Brooks, chairman of hematology/oncology
at the Ochsner Clinic Foundation in New Orleans.
"There is no safe level of
exposure to the carcinogens in tobacco smoke," he says. "Quitting
is absolutely the No. 1 thing an individual can do to reduce their
risk of ever developing cancer."
About one-third of cancers in the
United States are directly related to cigarette smoke, including
lung, throat, sinus, esophagus, pancreas, kidney and cervical
cancers, he says.
More information
Smokers can assess their risk of
lung cancer using the Memorial
Sloan-Kettering Cancer Center prediction tool. Or read about
diagnosis and treatments at the National
Cancer Institute.
Reference
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