Tobacco Smoking and Risk of Second Primary Lung Cancer
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Tobacco Smoking and Risk of Second Primary Lung Cancer. / Aredo, Jacqueline V.; Luo, Sophia J.; Gardner, Rebecca M.; Sanyal, Nilotpal; Choi, Eunji; Hickey, Thomas P.; Riley, Thomas L.; Huang, Wen-Yi; Kurian, Allison W.; Leung, Ann N.; Wilkens, Lynne R.; Robbins, Hilary A.; Riboli, Elio; Kaaks, Rudolf; Tjonneland, Anne; Vermeulen, Roel C. H.; Panico, Salvatore; Marchand, Loic Le; Amos, Christopher I.; Hung, Rayjean J.; Freedman, Neal D.; Johansson, Mattias; Cheng, Iona; Wakelee, Heather A.; Han, Summer S.
In: Journal of Thoracic Oncology, Vol. 16, No. 6, 2021, p. 968-979.Research output: Contribution to journal › Journal article › peer-review
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TY - JOUR
T1 - Tobacco Smoking and Risk of Second Primary Lung Cancer
AU - Aredo, Jacqueline V.
AU - Luo, Sophia J.
AU - Gardner, Rebecca M.
AU - Sanyal, Nilotpal
AU - Choi, Eunji
AU - Hickey, Thomas P.
AU - Riley, Thomas L.
AU - Huang, Wen-Yi
AU - Kurian, Allison W.
AU - Leung, Ann N.
AU - Wilkens, Lynne R.
AU - Robbins, Hilary A.
AU - Riboli, Elio
AU - Kaaks, Rudolf
AU - Tjonneland, Anne
AU - Vermeulen, Roel C. H.
AU - Panico, Salvatore
AU - Marchand, Loic Le
AU - Amos, Christopher I.
AU - Hung, Rayjean J.
AU - Freedman, Neal D.
AU - Johansson, Mattias
AU - Cheng, Iona
AU - Wakelee, Heather A.
AU - Han, Summer S.
PY - 2021
Y1 - 2021
N2 - Introduction: Lung cancer survivors are at high risk of developing a second primary lung cancer (SPLC). However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. We examined the risk factors for SPLC across multiple epidemiologic cohorts and evaluated the impact of smoking cessation on reducing SPLC risk.Methods: We analyzed data from 7059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. Cause-specific proportional hazards models estimated SPLC risk. We conducted validation studies using the Prostate, Lung,Colorectal, and Ovarian Cancer Screening Trial (N = 3423 IPLC cases) and European Prospective Investigation into Cancer and Nutrition (N = 4731 IPLC cases) cohorts and pooled the SPLC risk estimates using random effects meta analysis.Results: Overall, 163 MEC cases (2.3%) developed SPLC. Smoking pack-years (hazard ratio [HR] = 1.18 per 10 pack years, p < 0.001) and smoking intensity (HR = 1.30 per 10 cigarettes per day, p < 0.001) were significantly associated with increased SPLC risk. Individuals who met the 2013 U.S. Preventive Services Task Force's screening criteria at IPLC diagnosis also had an increased SPLC risk (HR = 1.92; p < 0.001). Validation studies with the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and European Prospective Investigation into Cancer and Nutrition revealed consistent results. Meta-analysis yielded pooled HRs of 1.16 per 10 pack-years (p(meta) < 0.001), 1.25 per 10 cigarettes per day (p(meta) < 0.001), and 1.99 (p(meta) < 0.001) for meeting the U.S. Preventive Services Task Force's criteria. In MEC, smoking cessation after IPLC diagnosis was associated with an 83% reduction in SPLC risk (HR = 0.17; p < 0.001).Conclusions: Tobacco smoking is a risk factor for SPLC. Smoking cessation may reduce the risk of SPLC. Additional strategies for SPLC surveillance and screening are warranted. (C) 2021 International Association for the Study of Lung Cancer. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
AB - Introduction: Lung cancer survivors are at high risk of developing a second primary lung cancer (SPLC). However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. We examined the risk factors for SPLC across multiple epidemiologic cohorts and evaluated the impact of smoking cessation on reducing SPLC risk.Methods: We analyzed data from 7059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. Cause-specific proportional hazards models estimated SPLC risk. We conducted validation studies using the Prostate, Lung,Colorectal, and Ovarian Cancer Screening Trial (N = 3423 IPLC cases) and European Prospective Investigation into Cancer and Nutrition (N = 4731 IPLC cases) cohorts and pooled the SPLC risk estimates using random effects meta analysis.Results: Overall, 163 MEC cases (2.3%) developed SPLC. Smoking pack-years (hazard ratio [HR] = 1.18 per 10 pack years, p < 0.001) and smoking intensity (HR = 1.30 per 10 cigarettes per day, p < 0.001) were significantly associated with increased SPLC risk. Individuals who met the 2013 U.S. Preventive Services Task Force's screening criteria at IPLC diagnosis also had an increased SPLC risk (HR = 1.92; p < 0.001). Validation studies with the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and European Prospective Investigation into Cancer and Nutrition revealed consistent results. Meta-analysis yielded pooled HRs of 1.16 per 10 pack-years (p(meta) < 0.001), 1.25 per 10 cigarettes per day (p(meta) < 0.001), and 1.99 (p(meta) < 0.001) for meeting the U.S. Preventive Services Task Force's criteria. In MEC, smoking cessation after IPLC diagnosis was associated with an 83% reduction in SPLC risk (HR = 0.17; p < 0.001).Conclusions: Tobacco smoking is a risk factor for SPLC. Smoking cessation may reduce the risk of SPLC. Additional strategies for SPLC surveillance and screening are warranted. (C) 2021 International Association for the Study of Lung Cancer. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
KW - Second primary lung cancer
KW - Tobacco smoking
KW - Smoking cessation
KW - Surveillance
KW - Screening
KW - HISTORY
KW - EPIDEMIOLOGY
KW - RESECTION
KW - SURVIVAL
KW - OUTCOMES
KW - MODEL
U2 - 10.1016/j.jtho.2021.02.024
DO - 10.1016/j.jtho.2021.02.024
M3 - Journal article
C2 - 33722709
VL - 16
SP - 968
EP - 979
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 6
ER -
ID: 270715288