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Stopping smoking after a diagnosis of early lung cancer is related to longer survival
Clinical Question
Is it useful for people to quit smoking after a diagnosis of lung cancer?
Bottom line
It seems there's still a benefit to quitting smoking after diagnosis, at least in patients with early-stage lung cancer. Newly diagnosed patients may be fatalistic, but you can let them know that quitting, even after diagnosis, is associated with an increase in life span (an average of almost 2 years) and an increase in the 5-year survival rate to 60%. 1b
Reference
Study design: Cohort (prospective)
Funding: Foundation
Setting: Outpatient (specialty)
Synopsis
These investigators enrolled 517 current smokers (average = 47 pack-years) who were newly diagnosed with early-stage (IA-IIIA) non–small cell lung cancer and followed them for an average of 7 years. The study was conducted in Russia, which is notable only because we don't see many studies from Russia in the major journals. Most of the patients were treated with surgery (88%) and radiation therapy (78%); 57.4% continued smoking. Of those who quit smoking, most (71.3%) quit at the time of diagnosis, another 15% quit within the first year, and another 13.6% quit more than one year after diagnosis. Over 7 years, 63.2% of patients died; 83% of these deaths were cancer-related. This rate is higher than in the United States. Patients who quit smoking lived a median 21.6 months longer (6.6 vs 4.8 years; P = .001). Five-year overall survival was higher among the patients who quit smoking (60.6% vs 48.6%; number needed to treat = 9).
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA