15. Smokers, Former Smokers, Women Smokers, and Lung Cancer
Claudia Henschke
Claudia I. Henschke, Radiology, Weill Cornell Medical College, led the largest clinical trial of lung-cancer computed tomography (CT) screening ever conduCTed—involving 30,235 men and women at 38 institutions across the globe—and the first study to link tumor size and lung cancer stage in an asymptomatic population. The study confirmed the importance of CT screening for identifying small lesions, which are a good indicator of early, curable cancer, and revealed that smokers and former smokers should be screened for lung cancer even if they do not have symptoms. The smaller the lung cancer is at diagnosis, the more likely it is to be stage 1 and curable. When lung cancer is detected outside of screening, typically because of symptoms, it has often spread to the lymph nodes and beyond. Curative resection or any effective treatment is greatly diminished at this point. Henschke urges smokers to elect annual CT screening because they are at high risk of lung cancer. Former smokers remain at high risk for lung cancer for 20 or 30 years after they quit smoking, so annual CT screening is valid. The International Early Lung Cancer Action Project (I-ELCAP), led by Henschke, has brought forth new information that will help physicians and patients with informed decision making about CT screening for lung cancer.
Another study led by Henschke, involving 17,000 U.S. smokers, confirmed that women are twice as likely to develop lung cancer as men. The study, however, found that women are 52 percent less likely to die from the disease. Gender differences in lung cancer have been poorly understood until now. These findings highlight the need to teach young women that they are at higher risk of developing the disease even when they are smoking the same amount as men. Lung cancer remains the leading cause of cancer death in both men and women, killing more people than breast, prostate, and colon cancers combined, according to the American Cancer Society.