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K. Pirie

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    PL04 - How Can We Stop the Epidemic of Lung Cancer? (ID 75)

    • Event: WCLC 2013
    • Type: Plenary Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      PL04.1 - Risk Reduction by Stopping Smoking (ID 638)

      08:15 - 09:45  |  Author(s): K. Pirie

      • Abstract
      • Slides

      Smoking is the most important cause of lung cancer and of death and morbidity from a wide range of causes. In most of Europe, North America and Australia recent results show that two-thirds of all deaths among male and female smokers in their 50s, 60s and 70s are caused by smoking. Smokers lose at least 10 years of lifespan. It takes decades for the full effects of smoking to emerge in a population. The hazards of smoking have been well described in men, but only recently have sufficiently large numbers of women in western countries been smoking for long enough for the full effects to be evident. For example, in the Million Women Study, a prospective study of 1.3 million UK women, lung cancer death rates in smokers were 20 times higher than in never smoker. Even in women who smoked fewer than 10 cigarettes per day, lung cancer rates were increased 10 fold, whereas among women who smoked about 25 cigarettes per day the risk was increased almost 40 fold. Risks were greater the younger women were when they started smoking. In western countries women began smoking in large numbers more than 50 years ago, and it is only now that results show clearly that when women smoke as much as men their risk of lung cancer and other conditions are similar. In Asia the full effects of smoking are still not evident, since large proportions of the population smoking began only a few decades ago. Stopping smoking substantially reduces the risks of lung cancer and of other conditions that would have occurred with continued smoking. Stopping at any age is beneficial. In the Million Women Study stopping at age 40 years was associated with a 3 fold increase in lung cancer, thus avoiding about 90% of the 20-fold excess mortality from lung cancer caused by continued smoking. Stopping smoking at around age 30 avoided about 97% of the excess risk of lung cancer. Similar findings have been reported from the USA and elsewhere. The avoidance of most of the excess risk of lung cancer and other adverse effects of continuing smoking by quitting before about age 40 years has major public health implications. It is estimated that during the 20th century smoking caused about 100 million deaths worldwide, but that it will cause ten times as many - 1000 million deaths - in the 21st century if current smoking patterns continue. If current smoking patterns continue almost all the smoking-related excess lung cancers and deaths in the next 50 or so years will occur in people who are already smoking. Much of the predicted epidemic of smoking-related deaths in the next 50 could be avoided if people who now smoke stopped, preferably before age 40.

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