It's Never Too Late To Quit Smoking
- A seven-year study of 517 Russians diagnosed with early-stage non-small cell lung cancer found that smoking cessation was linked to reductions in disease progression, declines in cancer-specific mortality and decreases in all-cause mortality.
- Compared with patients who continued smoking after their diagnosis, those who quit had 33% decreased risk for overall mortality, 25% decreased risk for cancer-specific mortality, and a 21.6 month increase in median survival time.
- 132,000 people are expected to die in the U.S. from lung cancer in 2021, and 80% of those diagnosed with the disease have a history of smoking while 50% are smokers at the time of their diagnosis.
A seven-year study of 517 Russians diagnosed with early-stage non-small cell lung cancer found that smoking cessation was linked to reductions in disease progression, declines in cancer-specific mortality, and decreases in all-cause mortality.Read More
In the U.S., lung cancer is expected to claim nearly 132,000 lives in 2021 despite the decline in lung cancer mortality rates fueled by the recent advancements in treatment of the disease.
Researchers from the International Agency for Research on Cancer, who worked in collaboration with the N.N. Blokhin National Medical Research Centre of Oncology in Russia on the study, are hoping that the links between smoking cessation and improvements in overall and progression-free survival will encourage more to quit smoking after diagnosis.
“We found quitting smoking after diagnosis to be an important predictor of overall and progression-free survival in patients with early-stage NSCLC. Compared with patients who continued smoking in the follow-up period, those who quit smoking had 33% decreased risk for overall mortality and 25% decreased risk for cancer-specific mortality,” notes lead author Dr. Madhi Sheikh, a member of the Genetic Epidemiology Group at IARC.
“Furthermore, the median survival time was 21.6 months longer among those who quit smoking than those who continued smoking.”
He later pointed out that the beneficial effects of quitting smoking on the survival of patients with non-small-cell lung cancer “may be similar or even superior to those reported for the new and emerging targeted and immunotherapy therapeutics.”
All Lung Cancer Patients
- Median Survival Time: 5.2 years
- Probability of Survival at Five Years: 50.9%
Lung Cancer Patients Who Continued Smoking
- Median Survival Time: 4.8 years
- Median Progression-Free Survival: 3.9 years
- Median Time to Lung-Cancer Specific Mortality: 6.0 years
- Probability of Survival at Three Years: 66.2%
- Probability of Survival at Five Years: 48.6%
Lung Cancer Patients Who Quit Smoking After Diagnosis
- Median Survival Time: 6.6 years
- Median Progression-Free Survival: 5.7 years
- Median Time to Lung-Cancer Specific Mortality: 7.9 years
- Probability of Survival at Three Years: 74.5%
- Probability of Survival at Five Years: 60.6%
These numbers show that patients who quit smoking had longer median survival time (6.6 years v. 4.8. years), longer median progression-free survival (5.7 years v. 3.9 years) and longer median time to death from lung cancer (7.9 years vs. 6 years).
The study notes that the effects of smoking cessation were similar among patients with earlier- and later-stage tumors, mild to moderate and heavy cigarette smokers, and patients who received and those who did not receive chemotherapy or radiation therapy. The results were also similar when the study defined those who quit smoking as only those who quit within three months of diagnosis.
The task now is to find ways to help those smokers who are newly diagnosed with lung cancer to kick the habit.
“Unfortunately, despite this strong case for action, tobacco treatment has yet to become a standard component of cancer care delivery. The challenge is to implement this goal into practice,” notes Dr. Nancy A. Rigotti from the Tobacco Research and Treatment Center at Massachusetts General Hospital.
She says that there are a few programs that are currently working towards this end, citing the National Cancer Institute’s Cancer Center Cessation Initiative as one example. But it is not enough.
“[T]obacco cessation treatment must extend beyond large cancer centers to reach community cancer centers, community health centers, lung cancer screening sites, and other settings in which people receive cancer diagnoses and treatment,” explains Dr. Rigotti.
“It is not too late for cigarette smokers with cancer and cancer survivors to benefit from becoming smoke-free. We need to make this happen!”
Dramatic Drops in Lung Cancer Deaths
Cancer deaths rates are down across the board, with lung cancer and melanoma posting the biggest declines, according to the Annual Report to the Nation on the Status of Cancer, which was released last month.
The report examined cases from 2014 through 2018, and found that cancer death rates decreased an average of 2.2% per year among males and 1.7% per year among females. Overall, the mortality rates for 11 of the 19 cancers most common in men and 14 of the 20 most common in women declined in those years.
Melanoma and lung cancer had the most accelerated decline in both groups. Melanoma mortality rates declined by 5.7% per year for men and 4.4% per year for women, while lung cancer saw 5.2% and 4.3% decreases in men and women respectively.
“The declines in lung cancer and melanoma death rates are the result of progress across the entire cancer continuum – from reduced smoking rates to prevent cancer to discoveries such as targeted drug therapies and immune checkpoint inhibitors,” said Dr. Karen E. Knudsen, chief executive officer of the American Cancer Society.
“While we celebrate the progress, we must remain committed to research, patient support, and advocacy to make even greater progress to improve the lives of cancer patients and their families.”
It was not all good news though, with women seeing an increase in mortality rates for uterus, liver, brain, pancreas, and soft tissue including heart cancers while men also saw similar increases in many of the same areas as well as bones and joints and oral cavity and pharynx cancers.
The reversal of that trend is attributed in part to obesity.
“The continued decline in cancer death rates should be gratifying to the cancer research community, as evidence that scientific advances over several decades are making a real difference in outcomes at the population level,” said Dr. Norman E. “Ned” Sharpless, director of the National Cancer Institute, part of the National Institutes of Health.
“I believe we could achieve even further improvements if we address obesity, which has the potential to overtake tobacco use to become the leading modifiable factor associated with cancer.”
The annual report is a collaborative effort between The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries.