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- Title
Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers.
- Authors
Richardson, Gary E.; Tucker, Margaret A.; Venzon, David J.; Linnoila, Ilona; Phelps, Ruby; Phares, John C.; Edison, Margaret; Ihde, Daniel C.; Johnson, Bruce E.; Richardson, G E; Tucker, M A; Venzon, D J; Linnoila, R I; Phelps, R; Phares, J C; Edison, M; Ihde, D C; Johnson, B E
- Abstract
<bold>Objective: </bold>To determine the incidence of second primary cancers developing in patients surviving free of cancer for 2 or more years after treatment for small-cell lung cancer and to assess the potential effect of smoking cessation.<bold>Design: </bold>Retrospective review of 540 patients from a single institution with a median follow-up of 6.1 years.<bold>Setting: </bold>A single government institution (the National Cancer Institute).<bold>Patients: </bold>Consecutive sample of 540 patients with histologically confirmed small-cell lung cancer treated from 1973 through 1989 on therapeutic clinical trials.<bold>Measurements: </bold>The relative risk for second primary cancers and death were calculated in patients who remained free of cancer for 2 years after initiation of therapy. The relation of these end points to smoking history was also determined.<bold>Results: </bold>Fifty-five patients (10%) were free of cancer 2 years after initiation of therapy. Eighteen of these patients developed one or more second primary cancers, including 13 who developed second primary non-small-cell lung cancer. The risk for any second primary cancer compared with that in the general population was increased four times (relative risk, 4.4; 95% CI, 2.5-7.2), with a relative risk of a second primary non-small-cell lung cancer of 16 (CI, 8.4-27). Forty-three patients discontinued smoking within 6 months of starting treatment for small-cell lung cancer, and 12 continued to smoke. In those who stopped smoking at time of diagnosis, the relative risk of a second lung cancer was 11 (CI, 4.4 to 23), whereas, in those who continued to smoke, it was 32 (CI, 12 to 69).<bold>Conclusions: </bold>Patients with small-cell lung cancer who survive cancer-free for more than 2 years have a significantly increased risk for development of a second primary smoking-related cancer. Cigarette smoking cessation after successful therapy is associated with a decrease in risk for a second smoking-related primary cancer.
- Subjects
LUNG cancer; NICOTINE addiction treatment
- Publication
Annals of Internal Medicine, 1993, Vol 119, Issue 5, p383
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-119-5-199309010-00006