Smoking and lung cancer

Günümüzde erişkinlerin yaklaşık üçte birinin sigara içtiği ve kadın nüfusunda sigara içme oranının arttığı bilinmektedir. Tütün kullanımıyla ilişkilendirilebilir ölümlerin 2025 yılında 10 milyona çıkacağı tahmin edilmektedir ve tüm erişkin ölümlerinin üçte birinin sigara içmekten kaynaklanacağı öngörülmektir. Sigara ve akciğer kanseri arasındaki ilişki geniş kapsamlı çalışmalarla ispatlanmıştır. Tütün kullanımı erkeklerin %90'ında, kadınların ise %79'unda akciğer kanserinin ana nedeni olarak bildirilmiştir. Akciğer kanserinden ölümlerin %90'ının sigara içmeyle ilişkisi olduğu tahmin edilmektedir. Sigara içenlerde akciğer kanseri gelişme riski sigara içmeyenlerle karşılaştırıldığında 20-40 kat daha yüksektir. Çevresel sigara içilmesine maruz kalma ve sigara içişinin farklı tipleri, akciğer kanserine sebep olarak gösterilmiştir. Son dekadlarda, kadın popülasyonu arasında sigara içme oranlarının artması ve "light" sigara kullanımının artmasından dolayı skuamöz ve küçük hücreli akciğer kanseri tipinden adenokarsinomaya bir değişme vardır. Sigarayı bıraktıktan sonra, akciğer kanserinden kümülatif ölüm riski azalmaktadır. Sigara içmeye devam eden hastanın kanser tedavisinde daha büyük zorluklar olmaktadır. Sigarayı bırakmak, kanserli hastalarda hayatta kalma süresini uzatabilir ve akciğer kanseri nüks riskini azaltabilir. Hekimler, güvenli yaşamak ve sigarayla ilişkili tehlikelerden korunmak için kanserli ve sağlıklı bireylerin hepsine sigarayı bırakmayı tavsiye etmelidir.

Sigara ve akciğer kanseri

Nowadays, around one-third of adults are known to be smokers, and smoking rates are increasing among the female population. It is estimated that deaths attributable to tobacco use will rise to 10 million by 2025, and one-third of all adult deaths are expected to be related to cigarette smoking. The association between cigarettes and lung cancer has been proven by large cohort studies. Tobacco use has been reported to be the main cause of 90% of male and 79% of female lung cancers. 90% of deaths from lung cancer are estimated to be due to smoking. The risk of lung cancer development is 20-40 times higher in lifelong smokers compared to non-smokers. Environmental cigarette smoke exposure and different types of smoking have been shown to cause pulmonary carcinoma. DNA adducts, the metabolites of smoke carcinogens bound coualently with DNA, are regarded as an indicator of cancer risk in smokers. In recent decades, there has been a shift from squamous and small cell lung cancer types to adenocarcinoma, due to increasing rates of smoking among female population and rising light cigarette usage. After smoking cessation, the cumulative death risk from lung cancer decreases. Patients who continue smoking experience greater difficulties during cancer treatment. Stopping smoking may prolong survival in cancer patients, and also decreases the risk of recurrent pulmonary carcinoma. In order to save lives and prevent smoking related hazards, physicians should advise both healthy individuals and those with cancer of the benefits of stopping smoking.

PDF

___

1. Tobacco or Health: a global status report. Genova, World Health Organization, 1997.
2. Kuper H, Adami HO, Boffetta P. Tobacco use, cancer causation and public health impact. J Intern Med 2002; 251: 455-66.
3. Chaloupka FJ. Development in Practice. Curbing the Epidemic: Governments and the Economics of Tobacco Control. Washington DC: The World Bank, 1999.
4. Zhang H, Cai B. The impact of tobacco on lung health in China. Respirology 2003; 8: 17-21.
5. Available from http: //www.who.int/tobacco/about/en/
6. ATS. Cigarette smoking and health. Am J Respir Crit Care Med 1996; 153: 861-5.
7. Available http://www.emro.who.int/Publications/HealthEdReligion/Smoking/QA.htm
8. Christiani DC. Smoking and the molecular epidemiology of lung cancer. Clin Chest Med 2000; 21: 87-93.
9. Doll R, Hill AB. Smoking and carcinoma of the lung; preliminary report. Br Med J 1950; 2: 739-48.
10. Wynder EL, Graham EA. Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma. A study of six hundred and eighty-four proved cases. JAMA 1950; 143: 319-26.
11. US Department of Health, Education, and Welfare. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public health service. Public Health Service Publication no. 1103, 1964.
12. Hoffmann D, Hoffmann I, El-Bayoumy K. The less harmful cigarette: a controversial issue, a tribute to Ernst L Wynder. Chem Res Toxicol 2001; 14: 767-90.
13. Montesano R, Hall J. Environmental causes of human cancers. Eur J Cancer 2001; 37: 67-87.
14. Kuper H, Boffetta P, Adami HO. Tobacco use and cancer causation: association by tumour type. J Intern Med 2002; 252: 206-24.
15. Peto R, Lopez AD, Boreham J, et al. Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet 1992; 339: 1268-78.
16. Newcomb PA, Carbone PP. The health consequences of smoking. Cancer. Med Clin North Am 1992; 76: 305-31.
17. Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 1999; 83: 18-29.
18. Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999; 49: 33-64.
19. Bilello KS, Murin S, Matthay RA. Epidemiology, etiology, and prevention of lung cancer. Clin Chest Med 2002; 23:1-25
20. La Vecchia C, Franceschi S, Levi F. Epidemiological research on cancer with a focus on Europe. Eur J Cancer Prev 2003; 12: 5-14.
21. Wingo PA, Ries LA, Giovino GA, et al. Annual report to the nation on the status of cancer, 1973-1996, with a special section on lung cancer and tobacco smoking. J Nal Cancer Inst 1999; 91: 675-90.
22. Shopland DR. Tobacco use and its contribution to early cancer mortality with a special emphasis on cigarette smoking. Environ Health Perspect 1995; 103: 131-42.
23. Peto R, Darby S, Deo H, et al. Smoking, smoking cessation, and lung cancer in the UK since 1950: combinationof national statistics with two case-control studies. BMJ 2000; 321: 323-9.
24. Simonato L, Agudo A, Ahrens W, et al. Lung cancer and cigarette smoking in Europe: an update of risk estimates and an assessment of inter-country heterogeneity. Int J Cancer 2001; 91: 876-87.
25. Erren TC, Jacobsen M, Piekarski C. Synergy between as bestos and smoking on lung cancer risks. Epidemiology 1999; 10:405-11.
26. Berry G, Liddell FD. The interaction of asbestos and smoking in lung cancer: a modified measure of effect. Ann Occup Hyg 2004; 48: 459-62.
27. Lee PN. Relation between exposure to asbestos and smoking jointly and the risk of lung cancer. Occup Environ Med 2001; 58: 145-53.
28. Tyczynski JE, Bray F, Parkin DM. Lung cancer in Europe in 2000: epidemiology, prevention, and early detection. Lancet Oncol 2003; 4: 45-55.
29. Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J 1976; 2:1525-36.
30. Rogot E, Murray JL. Smoking and causes of death among US veterans: 16 years of observation. Public Health Rep 1980; 95: 213-22.
31. Wright GS, Gruidl ME. Early detection and prevention of lung cancer. Curr Opin Oncol 2000; 12; 143-8.
32. Ozlu T, Bulbul Y, Oztuna F, Can G. Time course from first symptom to the treatment of lung cancer in the Eastern Black sea Region of Turkey. Med Princ Prach.2004; 13:211-4.
33. Capewell S, Sankaran R, Lamb D, et al. Lung cancer in lifelong non-smokers. Edinburgh Lung Cancer Group.Thorax 1991; 46: 565-8.
34. Engeland A, Haldorsen Tr Andersen A, Tretli S. The impact of smoking habits on lung cancer risk: 28 years' observation of 26.000 Norwegian men and women. Cancer Causes Control 1996; 7: 366-76.
35. Agudo A, Ahrens W, Benhamou E, et al. Lung cancer and cigarette smoking in women: a multicenter casecontrol study in Europe. Int J Cancer 2000; 88: 820-7.
36. Kreuzer M, Boffetta P, Whitley E, et al. Gender differences in lung cancer risk by smoking: a multicentre case-control study in Germany and Italy. Br J Cancer 2000; 82:227-33.
37. Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 1981; 66: 1191-308.
38. Weiss W. Cigarette smoking and lung cancer trends. A light at the end of the tunnel? Chest 1997; 111: 1414-6.
39. Devesa SS, Grauman DJ, Blot WJ, Fraumeni JF. Cancer surveillance series: changing geographic patterns of lung cancer mortality in the United States, 1950 through 1994. J Natl Cancer Inst 1999; 91: 1040-50.
40. Lubin JH, Blot WJ, Berrino F, et al. Patterns of lung cancer risk according to type of cigarette smoked. Int J Cancer 1984; 33: 569-76.
41. Camoirano A, Bagnasco M, Bennicelli C, et al. Oltipraz chemoprevention trial in Qidong, People's Republic of China: results of urine genotoxicity assays as related to smoking habits. Cancer Epidemiol Biomarkers Prev 2001; 10: 775-83.
42. Shapiro JA, Jacobs EJ, Thun MJ. Cigar smoking in men and risk of death from tobacco-related cancers. J Natl Cancer Inst 2000; 92: 333-7.
43. Boffetta P, Pershagen G, Jockel KH, et al. Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe. J Natl Cancer Inst 1999; 91:697-701.
44. Richardson TL. African-American smokers and cancers of the lung and of the upper respiratory and digestive tracts. Is menthol part of the puzzle? West J Med 1997; 166: 189-94.
45. Schmeltz I, Schlotzhauer WS. Benzo(a)pyrene, phenols and other products from pyrolysis of the cigarette additive, (d,1)-menthol. Nature 1968; 219: 370-1.
46. Clark PI, Gautam S, Gerson LW. Effect of menthol cigarettes on biochemical markers of smoke exposure among black and white smokers. Chest 1996; 110: 1194-8.
47. Orani GP, Anderson JW, Sant'Ambrogio G, Sant'Ambrogio FB. Upper airway cooling and l-menthol reduce ventilation in the guinea pig. J Appl Physiol 1991; 70:2080-6.
48. Carpenter CL, Jarvik ME, Morgenstern H, et al. Mentholated cigarette smoking and lung-cancer risk. Ann Epidemiol 1999; 9: 114-20.
49. Kabat GC, Hebert JR. Use of mentholated cigarettes and lung cancer risk. Cancer Res 1991; 51: 6510-3.
5O. Sidney S, Tekawa IS, Friedman GD, et al. Mentholated cigarette use and lung cancer. Arch Intern Med 1995; 155: 727-32.
51. Stellman SD, Muscat JE, Thompson S, et al. Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking. Cancer 1997; 80: 382-8.
52. Thun MJ, Lally CA, Flannery JT, et al. Cigarette smoking and changes in the histopathology of lung cancer. J Natl Cancer Inst 1997; 89: 1580-6.
53. Bray F, Sankila R, Ferlay J, Parkin DM. Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 2002; 38: 99-166.
54. Hirayama T. Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan. Br Med J (Clin Res Ed) 1981; 282: 183-5.
55. Trichopoulos D, Kalandidi A, Sparros L, MacMahon B. Lung cancer and passive smoking. Int J Cancer 1981;27: 1-4.
56. Garfinkel L. Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. J Natl Cancer Inst 1981; 66: 1061-66
57. Dockery DW, Trichopoulos D. Risk of lung cancer from environmental exposures to tobacco smoke. Cancer Causes Control 1997; 8: 333-45.
58. Zhong L, Goldberg MS, Parent ME, Hanley JA. Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis. Lung Cancer 2000; 27: 3-18.
59. Hackshaw AK, Law MR, Wald NJ. The accumulated evidence on lung cancer and environmental tobacco smoke. BMJ 1997; 315: 980-8.
60. Anderson KE, Carmella SG, Ye M, et al. Metabolites of a tobacco-specific lung carcinogen in nonsmoking women exposed to environmental tobacco smoke. J Natl Cancer Inst 2001; 93: 378-81.
61. Hecht SS, Carmella SG, Murphy SE, et al. A tobacco-specific lung carcinogen in the urine of men exposed to cigarette smoke. N Engl J Med 1993; 329: 1543-6.
62. Maclure M, Katz RB, Bryant MS, et al. Elevated blood levels of carcinogens in passive smokers. Am J Public Health 1989; 79: 1381-4.
63. Hecht SS. Environmental tobacco smoke and lung cancer: the emerging role of carcinogen biomarkers and molecular epidemiology: J Natl Cancer Inst 1994; 86: 1369-70.
64. Cardenas VM, Thun MJ, Austin H, et al. Environmental tobacco smoke and lung cancer mortality in the American Cancer Society's Cancer Prevention Study. II. Cancer Causes Control 1997; 8:57-64. |
65. Phillips DH, Hewer A, Martin CN, et al. Correlation of DNA adduct levels in human lung with cigarette smoking. Nature 1988; 336: 790-2.
66. Randerath E, Miller RH, Mittal D, et al. Covalent DNA damage in tissues of cigarette smokers as determined by 32P-postlabeling assay. J Natl Cancer Inst 1989; 81:341-7.
67. Santella RM, Grinberg-Funes RA, Young TL, et al. Ciga- rette smoking related polycyclic aromatic hydrocarbon DNA adducts in peripheral mononuclear cells. Carcino genesis 1992; 13:2041-5.
68. Toyooka S, Tsuda T, Gazdar AF. The TP53 gene, tobacco exposure, and lung cancer. Hum Mutat 2003; 21:229-39.
69. Bodner SM, Minna JD, Jensen SM, et al. Expression of mutant p53 proteins in lung cancer correlates with the class of p53 gene mutation. Oncogene 1992; 7: 743-9.
70. Takahashi T, Nau MM, Chiba I, et al. p53: a frequent tar get for genetic abnormalities in lung cancer. Science 1989; 246: 491-4.
71. Mao L Molecular abnormalities in lung carcinogenesis and their potential clinical implications. Lung Cancer 2001; 34 (Suppl 2): 27-34.
72. Hainaut P, Pfeifer GP. Patterns of p53 G→T transversions in lung cancers reflect the primary mutagenic signature, of DNA-damage by tobacco smoke. Carcinogenesis 2001; 22: 367-74.
73. Hainaut P, Olivier M, Pfeifer GP. TP53 mutation spectrum in lung cancers and mutagenic signature of components of tobacco smoke: lessons from the IARC TP53 mutation database. Mutagenesis 2001; 16:551-3.
74. Vahakangas KH, Bennett WP, Castren K, et al. p53 and K-ras mutations in lung cancers from former and never smoking women. Cancer Res 2001; 61: 4350-6.
75. Mao L, Hruban RH, Boyle JO, et al. Detection of oncoge ne mutations in sputum precedes diagnosis of lung can cer. Cancer Res 1994; 54: 1634-7.
76. Ahrendt SA, Chow JT, Yang SC, et al. Alcohol consump tion and cigarette smoking increase the frequency of p53 mutations in non-small cell lung cancer. Cancer Res 2000; 60: 3155-9.
77. Tanoue LT. Cigarette smoking and women's respiratory health. Clin Chest Med 2000; 21: 47-65.
78. Patel JD, Bach PB, Kris MG. Lung cancer in US women: a contemporary epidemic. JAMA 2004; 291:1763-8.
79. Kure EH, Ryberg D, Hewer A, et al. p53 mutations in lung tumours: relationship to gender and lung DNA ad duct levels. Carcinogenesis 1996; 17:2201-5.
80. Ryberg D, Hewer A, Phillips DH, Haugen A. Different susceptibility to smoking-induced DNA damage among male and female lung cancer patients. Cancer Res 1994; 54:5801-3.
81. Mollerup S, Ryberg D, Hewer A, et al. Sex differences in lung CYP1A1 expression and DNA adduct levels among lung cancer patients. Cancer Res 1999; 59: 3317-20.
82. Guengerich FP, Shimada T. Oxidation of toxic and carci nogenic chemicals by human cytochrome P-450 enzy- mes. Chem Res Toxicol 1991; 4:391-407.
83. Tang DL, Rundle A, Warburton D, et al. Associations bet ween both genetic and environmental biomarkers and lung cancer: evidence of a greater risk of lung cancer in women smokers. Carcinogenesis 1998; 19: 1949-53.
84. Dresler CM, Fratelli C, Babb J, et al. Gender differences in genetic susceptibility for lung cancer. Lung Cancer 2000; 30: 153-60.
85. Wei Q, Cheng L, Amos CI, et al. Repair of tobacco carci nogen-induced DNA adducts and lung cancer risk: a molecular epidemiologic study. J Natl Cancer Inst 2000; 92: 1764-72.
86. Nelson HH, Christiani DC, Mark EJ, et al.İmplications and prognostic value of K-ras mutation for early-stage lung cancer in women. J Natl Cancer Inst 1999; 91:2032-8.
87. Risch HA, Howe GR, Jain M, et al. Are female smokers at higher risk for lung cancer than male smokers? A ca se-control analysis by histologic type. Am J Epidemiol 1993; 138:281-93.
88. Zang EA, Wynder EL. Differences in lung cancer risk bet ween men and women: examination of the evidence. J Natl Cancer Inst 1996; 88: 183-92.
89. Shriver SP, Bourdeau HA, Gubish CT, et al. Sex-specific expression of gastrin-releasing peptide receptor: relati onship to smoking history and risk of lung cancer. J Natl Cancer Inst 2000; 92:24-33.
90. Osann KE, Anton-Culver H, Kurosaki T, Taylor T. Sex dif ferences in lung-cancer risk associated with cigarette smoking. Int J Cancer 1993; 54: 44-8.
91. Schoenberg JB, Klotz JB, Wilcox HB, et al. Case-control study of residential radon and lung cancer among New Jersey women. Cancer Res 1990; 50: 6520-4.
92. Bach PB, Kattan MW, Thornquist MD, et al. Variations in lung cancer risk among smokers. J Natl Cancer Inst 2003; 95: 470-8.
93. Zang EA, Wynder EL. Smoking trends in the United Sta tes between 1969 and 1995 based on patients hospitali sed with non-smoking related diseases. Preventive Medicine 1998;27:854-61
94. Levi F, Franceschi S, La Vecchia C, et al. Lung carcinoma trends by histologic type in Vaud and Neuchatel, Swit zerland, 1974-1994. Cancer 1997; 79: 906-14.
95. Payne S. 'Smoke like a man, die like a man'?: a review of the relationship between gender, sex and lung cancer. Soc Sci Med 2001; 53: 1067-80.
96. Hegmann KT, Fraser AM, Keaney RP, et al. The effect of age at smoking initiation on lung cancer risk. Epidemi ology 1993; 4: 444-8.
97. Jenks S. Gender may render women at risk for lung can cer. J Natl Cancer lnst 1996; 88: 144.
98. Gao YT, Blot WJ, Zheng W, et al. Lung cancer among Chi nese women. Int J Cancer 1987; 40: 604-9.
99. Taioli E, Wynder EL. Re: Endocrine factors andadenocar cinoma of the lung in women. J Natl Cancer Inst, 1994; 86:869-70.
100. Canver CC, Memoli VA, Vandergeer PL, et al. Sex hormo ne receptors in non-small-cell lung cancer in human be ings. J Thorac Cardiovasc Surg 1994; 108: 153-7.
101. Beattie CW, Hansen NW, Thomas PA. Steroid receptors in human lung cancer. Cancer Res 1985; 45: 4206-14.
102. Cagle PT, Mody DR, Schwartz MR. Estrogen and proges terone receptors in bronchogenic carcinoma. Cancer Res 1990; 50: 6632-5.
103. Tredaniel J, Boffetta P, Saracci R, Hirsch A. Non-smoker lung cancer deaths attributable to exposure to spouse's environmental tobacco smoke. Int J Epidemiol 1997; 26: 939-44.
104. Dresler CM, Gritz ER. Smoking, smoking cessation and the oncologist. Lung Cancer 2001; 34: 315-23.
105. Dauison AG, Duffy M. Smoking habits of long-term sur vivors of surgery for lung cancer. Thorax 1982; 37:331-3.
106. Gritz ER. Smoking and smoking cessation in cancer pa tients. Br J Addict 1991; 86: 549-54.
107. Dresler CM. Is it more important to quit smoking than which chemotherapy is used? Lung Cancer 2003; 39: 119-24.
108. Eckhardt SG, Pulte DE, Hilsenbeck S, et al. Response to chemotherapy in smoking and nonsmoking patients with non-small cell lung cancer. Proc ASCO 1995, Abst ract no: 1088.
109. Monson JM, Stark P, Reilly JJ, et al. Clinical radiation pneumonitis and radiographic changes after thoracic ra diation therapy for lung carcinoma. Cancer 1998; 82: 842-50.
110. Kawahara M, Ushijima S, Kamimori T, et al. Second pri mary tumours in more than 2-year disease-free survivors of small-cell lung cancer in Japan: the role of smoking cessation. Br J Cancer 1998; 78: 409-12.
111. Levi F, Randimbison L, Te VC, La Vecchia C. Second pri mary cancers in patients with lung carcinoma. Cancer 1999; 86: 186-90.
112. Tucker MA, Murray N, Shaw EG, et al. Second primary cancers related to smoking and treatment of small-cell lung cancer. Lung Cancer Working Cadre. J Natl Cancer lnst 1997; 89: 1782-8.
113. Richardson GE, Tucker MA, Venzon DJ, et al. Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers. Ann Intern Med 1993; 119: 383-90.
114. Hayashi K, Fukushima K, Sagara Y, Takeshita M. Surgi İ cal treatment for patients with lung cancer complicated by severe pulmonary emphysema. Jpn J Thorac Cardi ovasc Surg 1999; 47: 583-7.
115. Johnson BE, Ihde DC, Matthews MJ, et al. Non-small-cell lung cancer. Major cause of late mortality in patients with small cell lung cancer. Am J Med 1986;80:1103-10.
116. Johnston-Early A, Cohen MH, Minna JD, et al. Smoking abstinence and small cell lung cancer survival. An as sociation. JAMA 1980; 244: 2175-9.
117. Pearce AC, Jones RM. Smoking and anaesthesia: preop erative.abstinence and perioperative morbidity. Anaest hesiology 1984; 61:576-84.
118. Tammemagi CM, Neslund-Dudas C, Simoff M, Kvale P. Smoking and lung cancer survival: the role of comor bidity and treatment. Chest 2004; 125:27-37.
119. Cox LS, Africano NL, Tercyak KP, Taylor KL. Nicotine dependence treatment for patients with cancer. Cancer 2003; 98: 632-44.
120. Gritz ER, Schacherer C, Koehly L, et al. Smoking withd rawal and relapse in head and neck cancer patients. Head Neck 1999; 21: 420-7.
121. Volm M, Samsel B, Mattern J. Relationship between chemoresistance of lung tumours and cigarette smoking. Br J Cancer 1990; 62: 255-6.
122. Knudsen N, Schulman S, van den Hoek J, Fowler R. In sights on how to quit smoking: a survey of patients with lung cancer. Cancer Nurs 1985; 8: 145-50.
123. Dresler CM, Bailey M, Roper CR, et al. Smoking cessation and lung cancer resection. Chest 1996; 110: 1199-202.
124. Can G, Oztuna F, Ozlu T. The evaluation of outpatient smoking cessation clinic results. Tuberk Toraks 2004; 52: 63-74.