Release date: 2017-03-17

Lead: Smoking does not necessarily have cancer, but the risk of cancer is definitely higher than that of non-smokers.

According to data released by the National Cancer Center, with the increase in morbidity and mortality, cancer has become the leading cause of death and major public health problems in the Chinese population. China estimated an estimated 4292,000 new cancer cases and 2814,000 cancer deaths in 2015. Lung cancer is the most common cancer and the leading cause of cancer death.

The relationship between smoking and cancer has not been proven, and about one-third of cancer deaths are caused directly by smoking. According to statistics, 85% to 90% of lung cancers in the United States are related to smoking, while cancers in the respiratory tract, upper digestive tract, oral cavity, nasal cavity, kidney and bladder are closely related to smoking.

According to a study in the Cancer Journal, 430,000 people in China suffer from new cancers every year, and a quarter of men's cancers are caused by smoking. In addition, due to the high proportion of adolescents before the age of 20 who become smokers, the cancer caused by tobacco will continue to increase.

Up to now, Xiaobian has reviewed the latest literature and updated the relationship between tobacco and cancer prediction, treatment and outcome prevention. There are 10 facts as follows:

1. Smokers have a 44% increased risk of cancer compared with non-smokers. A study in Cancer magazine enrolled 500,000 residents in China. During the 7-year follow-up, 25,000 people died, and 18,000 of them died of cancer.

2. There is no safe smoking level. Even if there is less than one cigarette per day, the risk of death is higher than that of non-smokers. A new study in JAMA magazine shows that smoking less than 1 pack per day still has a higher risk of early death than non-smokers.

3. Compared with men, only 3% of women smoked, and women smokers had a 42% higher risk of cancer than non-smokers.

4. Smoking is associated with many other cancers (Figure 1). Among them, smoking has the highest risk of lung cancer. Compared with non-smokers, the risk of lung cancer is increased by 151%, the risk of liver cancer is increased by 32%, the risk of gastric cancer is increased by 34%, and the risk of esophageal cancer is increased by 47%.

Figure 1 Health consequences associated with smoking

5. Smoking not only affects the incidence of EGFR mutations in patients with lung adenocarcinoma, but also affects EGFR mutation sites. Provides clues for further study of EGFR mutations.

6. Cancer patients who smoke are experiencing more severe symptoms than those who do not smoke, and the risk of abuse of opioids is higher. Smokers' physical symptoms (pain, fatigue, loss of appetite, insomnia, etc.) and psychological symptoms (depression and communication) are more severe.

7. Smoking increases the patient's all-cause mortality, breast cancer mortality, respiratory cancer mortality, and cardiovascular mortality. Among them, the risk of death was higher in the case of smokers who were diagnosed and who were still smokers after diagnosis.

8. Aromatase inhibitor therapy is associated with an increased risk of breast cancer events and distant metastases in patients with a history of breast cancer before surgery. If this result is supported by more evidence, future options for endocrine therapy for breast cancer patients should consider smoking.

9. Preliminary studies have found that autoantibodies, immune proteins specific to their own proteins found in the blood, can identify whether a smoker has lung cancer at an early stage. This method can also distinguish between lung cancer and low-dose CT (LDCT) detection. Non-cancer lung lesions.

10. A recent joint SRNT/ATTUD guidelines for smokers undergoing lung cancer screening and smoking cessation treatments show that for smokers who are screened for lung cancer, doctors should recommend smoking cessation during screening.

In most developed countries, the number of deaths from tobacco-related diseases has steadily declined. However, China's current cigarette production and consumption has accounted for about 40% of the world's total. In the coming decades, a wide range of smoking cessation will be one of the most effective and effective strategies to avoid cancer and premature mortality.

references:

[1] Cancer statistics in China, 2015.CA Cancer J Clin 2016 Mar-Apr;66(2):115-32

[2] Active smoking and mortality among colorectal cancer survivors: the Cancer Prevention Study II nutrition cohort. J Clin Oncol 2015 Mar 10;33(8):885-93

[3]Comparative Study of Autoantibody Responses between Lung Adenocarcinoma and Benign Pulmonary Nodules.J Thorac Oncol 2016 Mar;11(3):334-45

[4] Divergent epidermal growth factor receptor mutation patterns between smokers and non-smokers with lung adenocarcinoma. Lung Cancer 2015 Dec;90(3):472-6

[5] Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco. Cancer 2016 Apr 15; 122(8): 1150-9

[6] Emerging tobacco-related cancer risks in China: A nationwide, prospective study of 0.5 million adults. Cancer 2015 Sep 1;121 Suppl 17:3097-106

[7]50th Anniversary Report: Even More Known About Smoking, Cancer Connections, OncLive, Tuesday, June 24, 2014

[8]Association of e-Cigarette Vaping and Progression to Heavier Patterns of Cigarette Smoking.JAMA 2016 Nov 8;316(18):1918-1920

[9]Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis. Cancer Epidemiol Biomarkers Prev 2014 Sep;23(9):1783-92

[10] Cigarette Smoking Before and After Breast Cancer Diagnosis: Mortality From Breast Cancer and Smoking-Related Diseases. JCO, Published online on January 25, 2016.

[11]Impacts of smoking on endocrine treatment response in a prospective breast cancer cohort.Br J Cancer 2016 Jul 26;115(3):382-90

Source: Medical Pulse

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