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Connection detected between sudden cessation of smoking and imminent lung cancer diagnosis
Campling BG. J Thorac Oncol. 2011;6:517-524.
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Spontaneous smoking cessation may be a presenting symptom of lung cancer, according to researchers.
From June 2004 to August 2006, researchers recruited 115 patients with lung cancer from the Philadelphia VA Medical Center and gave them a structured interview about their smoking habits before lung cancer diagnosis. Patients with prostate cancer (n=101) and those who had a myocardial infarction (n=99) were also interviewed. The type of cancer and date of diagnosis were taken from medical records.
Among former smokers, dates of cessation, onset of symptoms and diagnosis data were recorded. Nicotine addiction levels were measured using the Fagerström Test for Nicotine Dependence (FTND). Cigarette smokers were defined as those who had smoked 100 or more cigarettes in their lifetime. Difficulty of cessation and withdrawal symptoms were rated on a 0-10 scale, 10 being the most difficult or severe.
Of the patients with lung cancer, all 115 had been smokers; 48% had quit smoking before diagnosis; 11% were symptomatic when they quit. Lifetime exposure to tobacco for former smokers with lung cancer was much higher than in the prostate cancer and MI groups. The median difficulty of quitting was 3 for patients with lung cancer, 1 for those with prostate cancer and 0.5 for MI. The median of addiction severity was 7 for patients with lung cancer, 3 for those with prostate cancer and 4 for MI.
Among patients with moderate to high levels of addiction (FTND ≥5), 45.2% of those with lung cancer quit before diagnosis; for prostate cancer, it was 36.8% and 20% for MI (P=.007). Thirty-one percent of patients with lung cancer reported quitting with no difficulty.
“The simple observation that many patients with lung cancer quit smoking without difficulty before diagnosis has many implications. Recognition of this phenomenon as a presenting symptom of lung cancer could result in earlier diagnosis of this common, highly lethal cancer, which is curable only when diagnosed at an early stage. An understanding of the geological basis of this phenomenon could lead to new strategies for smoking cessation,” researchers wrote.
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