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Published in: Journal of Cancer Research and Clinical Oncology 5/2019

01-05-2019 | Lung Cancer | Original Article – Cancer Research

Disparity in age at lung cancer diagnosis between current and former smokers

Authors: Barbara G. Campling, Zhong Ye, Yinzhi Lai, Ling Li, Voichita Bar-Ad, Maria Werner-Wasik, Bo Lu, Scott W. Cowan, Nathaniel R. Evans, Inna Chervoneva, Chun Wang

Published in: Journal of Cancer Research and Clinical Oncology | Issue 5/2019

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Abstract

Purpose

In a previous study of smoking cessation in veterans with lung cancer, we noted as an incidental finding that current smokers were much younger than former smokers at diagnosis. To confirm and extend this observation, we analyzed the association of smoking status with age at diagnosis and survival of lung cancer patients.

Methods

The Jefferson Cancer Registry collects information on all cancer patients registered at this hospital. Information on smoking status has been recorded since 1995. We determined age at diagnosis and survival of current and former smokers with lung cancer.

Results

5111 lung cancer cases were identified in the registry from 1995 to 2011 inclusive. Smoking status was recorded in 4687 cases (91.7%). Of these, 1859 (39.7%) were current, 2423 (51.7%) were former, and 405 (8.6%) were never smokers. There was a 6-year difference in median age at lung cancer diagnosis between the current (63 years) and former smokers (69 years) (P < 0.0001). The median survival was 12.1 months for current versus 14.5 months for former smokers (P < 0.0001).

Conclusions

These results confirm and extend our observation that among patients diagnosed with lung cancer, current smokers are younger than former smokers. The possible explanations include higher competing causes of death and increased risk of lung cancer among current smokers as well as increasing proportions of former smokers in older populations. Ongoing exposure to tobacco carcinogens may accelerate the development of lung cancer in continuing smokers. This provides more incentive for smokers to quit at the earliest age possible.
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Literature
go back to reference American Joint Commission on Cancer (2007) AJCC cancer staging atlas. Springer, New York American Joint Commission on Cancer (2007) AJCC cancer staging atlas. Springer, New York
go back to reference American Joint Commission on Cancer (2009) AJCC cancer staging manual. Springer, New York American Joint Commission on Cancer (2009) AJCC cancer staging manual. Springer, New York
go back to reference Amos CI, Wu X, Broderick P et al (2008) Genome-wide association scan of tag SNPs identifies a susceptibility locus for lung cancer at 15q25.1. Nat Genet 40:616–622CrossRefPubMedPubMedCentral Amos CI, Wu X, Broderick P et al (2008) Genome-wide association scan of tag SNPs identifies a susceptibility locus for lung cancer at 15q25.1. Nat Genet 40:616–622CrossRefPubMedPubMedCentral
go back to reference Bhatt VR, Batra R, Silberstein PT et al (2015) Effect of smoking on survival from non-small cell lung cancer: a retrospective Veterans’ Affairs Central Cancer Registry (VACCR) cohort analysis. Med Oncol 32:339CrossRefPubMed Bhatt VR, Batra R, Silberstein PT et al (2015) Effect of smoking on survival from non-small cell lung cancer: a retrospective Veterans’ Affairs Central Cancer Registry (VACCR) cohort analysis. Med Oncol 32:339CrossRefPubMed
go back to reference Browman GP, Wong G, Hodson I et al (1993) Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Eng J Med 328:159–163CrossRef Browman GP, Wong G, Hodson I et al (1993) Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Eng J Med 328:159–163CrossRef
go back to reference Campling BG, Collins BN, Algazy KM et al (2011) Spontaneous smoking cessation before lung cancer diagnosis. J Thorac Oncol 6:517–524CrossRefPubMed Campling BG, Collins BN, Algazy KM et al (2011) Spontaneous smoking cessation before lung cancer diagnosis. J Thorac Oncol 6:517–524CrossRefPubMed
go back to reference Cattaneo MG, Codignola A, Vicentini LM et al (1993) Nicotine stimulates a serotonergic autocrine loop in human small-cell lung carcinoma. Cancer Res 53:5566–5568PubMed Cattaneo MG, Codignola A, Vicentini LM et al (1993) Nicotine stimulates a serotonergic autocrine loop in human small-cell lung carcinoma. Cancer Res 53:5566–5568PubMed
go back to reference Dasgupta P, Rastogi S, Pillai S et al (2006) Nicotine induces cell proliferation by beta-arrestin-mediated activation of Src and Rb-Raf-1 pathways. J Clin Invest 116:2208–2217CrossRefPubMedPubMedCentral Dasgupta P, Rastogi S, Pillai S et al (2006) Nicotine induces cell proliferation by beta-arrestin-mediated activation of Src and Rb-Raf-1 pathways. J Clin Invest 116:2208–2217CrossRefPubMedPubMedCentral
go back to reference Detterbeck FC, Mazzone PJ, Naidich DP et al (2013) Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e78S–e92SCrossRefPubMedPubMedCentral Detterbeck FC, Mazzone PJ, Naidich DP et al (2013) Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143:e78S–e92SCrossRefPubMedPubMedCentral
go back to reference Ferketich AK, Niland JC, Mamet R et al (2013) Smoking status and survival in the National Comprehensive Cancer Network non-small cell lung cancer cohort. Cancer 119:847–853CrossRefPubMed Ferketich AK, Niland JC, Mamet R et al (2013) Smoking status and survival in the National Comprehensive Cancer Network non-small cell lung cancer cohort. Cancer 119:847–853CrossRefPubMed
go back to reference Fleshner N, Garland J, Moadel A et al (1999) Influence of smoking status on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma of the bladder. Cancer 86:2337–2345CrossRefPubMed Fleshner N, Garland J, Moadel A et al (1999) Influence of smoking status on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma of the bladder. Cancer 86:2337–2345CrossRefPubMed
go back to reference Halpern MT, Gillespie BW, Warner KE (1993) Patterns of absolute risk of lung cancer mortality in former smokers. J Natl Cancer Inst 85:457–464CrossRefPubMed Halpern MT, Gillespie BW, Warner KE (1993) Patterns of absolute risk of lung cancer mortality in former smokers. J Natl Cancer Inst 85:457–464CrossRefPubMed
go back to reference Heeschen C, Jang JJ, Weis M et al (2001) Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med 7:833–839CrossRefPubMed Heeschen C, Jang JJ, Weis M et al (2001) Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med 7:833–839CrossRefPubMed
go back to reference Hung RJ, McKay JD, Gaborieau V et al (2008) A susceptibility locus for lung cancer maps to nicotinic acetylcholine receptor subunit genes on 15q25. Nature 452:633–637CrossRefPubMed Hung RJ, McKay JD, Gaborieau V et al (2008) A susceptibility locus for lung cancer maps to nicotinic acetylcholine receptor subunit genes on 15q25. Nature 452:633–637CrossRefPubMed
go back to reference Jaklitsch MT, Jacobson FL, Austin JH et al (2012) The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg 144:33–38CrossRefPubMed Jaklitsch MT, Jacobson FL, Austin JH et al (2012) The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg 144:33–38CrossRefPubMed
go back to reference Jamal A, Homa DM, O’Connor E et al (2015) Current cigarette smoking among adults-United States, 2005–2014. Morb Mortal Wkly Rep 64:1233–1240CrossRef Jamal A, Homa DM, O’Connor E et al (2015) Current cigarette smoking among adults-United States, 2005–2014. Morb Mortal Wkly Rep 64:1233–1240CrossRef
go back to reference Jha P, Ramasundarahettige C, Landsman V et al (2013) 21st-Century hazards of smoking and benefits of cessation in the United States. N Engl J Med 368:341–350CrossRefPubMed Jha P, Ramasundarahettige C, Landsman V et al (2013) 21st-Century hazards of smoking and benefits of cessation in the United States. N Engl J Med 368:341–350CrossRefPubMed
go back to reference Maneckjee R, Minna JD (1990) Opioid and nicotine receptors affect growth regulation of human lung cancer cell lines. Proc Natl Acad Sci USA 87:3294–3298CrossRefPubMed Maneckjee R, Minna JD (1990) Opioid and nicotine receptors affect growth regulation of human lung cancer cell lines. Proc Natl Acad Sci USA 87:3294–3298CrossRefPubMed
go back to reference Mayadev J, Lim J, Durbin-Johnson B et al (2018) Smoking decreases survival in locally advanced cervical cancer treated with radiation. Am J Clin Oncol 41:295–301CrossRefPubMedPubMedCentral Mayadev J, Lim J, Durbin-Johnson B et al (2018) Smoking decreases survival in locally advanced cervical cancer treated with radiation. Am J Clin Oncol 41:295–301CrossRefPubMedPubMedCentral
go back to reference Mong C, Garon EB, Fuller C et al (2011) High prevalence of lung cancer in a surgical cohort of lung cancer patients a decade after smoking cessation. J Cardiothorac Surg 6:1–7CrossRef Mong C, Garon EB, Fuller C et al (2011) High prevalence of lung cancer in a surgical cohort of lung cancer patients a decade after smoking cessation. J Cardiothorac Surg 6:1–7CrossRef
go back to reference Mousa S, Mousa SA (2006) Cellular and molecular mechanisms of nicotine’s pro-angiogenesis activity and its potential impact on cancer. J Cell Biochem 97:1370–1378CrossRefPubMed Mousa S, Mousa SA (2006) Cellular and molecular mechanisms of nicotine’s pro-angiogenesis activity and its potential impact on cancer. J Cell Biochem 97:1370–1378CrossRefPubMed
go back to reference Moyer VA, Force USPST (2014) Screening for lung cancer: US preventive services task force recommendation statement. Ann Intern Med 160:330–338PubMed Moyer VA, Force USPST (2014) Screening for lung cancer: US preventive services task force recommendation statement. Ann Intern Med 160:330–338PubMed
go back to reference Saccone SF (2007) Cholinergic nicotinic receptor genes implicated in a nicotine dependence association study targeting 348 candidate genes with 3713 SNPs. Hum Mol Genet 16:36–49CrossRefPubMed Saccone SF (2007) Cholinergic nicotinic receptor genes implicated in a nicotine dependence association study targeting 348 candidate genes with 3713 SNPs. Hum Mol Genet 16:36–49CrossRefPubMed
go back to reference Schuller HM (1989) Cell type specific, receptor-mediated modulation of growth kinetics in human lung cancer cell lines by nicotine and tobacco-related nitrosamines. Biochem Pharmacol 38:3439–3442CrossRefPubMed Schuller HM (1989) Cell type specific, receptor-mediated modulation of growth kinetics in human lung cancer cell lines by nicotine and tobacco-related nitrosamines. Biochem Pharmacol 38:3439–3442CrossRefPubMed
go back to reference Song P, Sekhon HS, Jia Y et al (2003) Acetylcholine is synthesized by and acts as an autocrine growth factor for small cell lung carcinoma. Cancer Res 63:214–221PubMed Song P, Sekhon HS, Jia Y et al (2003) Acetylcholine is synthesized by and acts as an autocrine growth factor for small cell lung carcinoma. Cancer Res 63:214–221PubMed
go back to reference Spitz MR, Amos CI, Dong Q et al (2008) The CHRNA5-A3 region on chromosome 15q24-25.1 is a risk factor both for nicotine dependence and for lung cancer. J Natl Cancer Inst 100:1552–1556CrossRefPubMedPubMedCentral Spitz MR, Amos CI, Dong Q et al (2008) The CHRNA5-A3 region on chromosome 15q24-25.1 is a risk factor both for nicotine dependence and for lung cancer. J Natl Cancer Inst 100:1552–1556CrossRefPubMedPubMedCentral
go back to reference Tammemagi CM, Neslund-Dudas C, Simoff M et al (2004) Smoking and lung cancer survival: The role of comorbidity and treatment. Chest 125:27–37CrossRefPubMed Tammemagi CM, Neslund-Dudas C, Simoff M et al (2004) Smoking and lung cancer survival: The role of comorbidity and treatment. Chest 125:27–37CrossRefPubMed
go back to reference The National Lung Screening Trial Research Team (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409CrossRefPubMedCentral The National Lung Screening Trial Research Team (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409CrossRefPubMedCentral
go back to reference Thorgeirsson TE, Geller F, Sulem P et al (2008) A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature 452:638–642CrossRefPubMedPubMedCentral Thorgeirsson TE, Geller F, Sulem P et al (2008) A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature 452:638–642CrossRefPubMedPubMedCentral
go back to reference Toh CK, Gao F, Lim WT et al (2006) Never-smokers with lung cancer: Epidemiologic evidence of a distinct disease entity. J Clin Oncol 24:2245–2251CrossRefPubMed Toh CK, Gao F, Lim WT et al (2006) Never-smokers with lung cancer: Epidemiologic evidence of a distinct disease entity. J Clin Oncol 24:2245–2251CrossRefPubMed
go back to reference Videtic GM, Stitt LW, Dar R et al (2003) Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol 21:1544–1549CrossRefPubMed Videtic GM, Stitt LW, Dar R et al (2003) Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol 21:1544–1549CrossRefPubMed
go back to reference Wood DE (2015) National comprehensive cancer network (NCCN) clinical practice guidelines for lung cancer screening. Thorac Surg Clin 25:185–197CrossRefPubMed Wood DE (2015) National comprehensive cancer network (NCCN) clinical practice guidelines for lung cancer screening. Thorac Surg Clin 25:185–197CrossRefPubMed
Metadata
Title
Disparity in age at lung cancer diagnosis between current and former smokers
Authors
Barbara G. Campling
Zhong Ye
Yinzhi Lai
Ling Li
Voichita Bar-Ad
Maria Werner-Wasik
Bo Lu
Scott W. Cowan
Nathaniel R. Evans
Inna Chervoneva
Chun Wang
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 5/2019
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-019-02875-6

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