Source: International Congress 2014 – Three smoking-related diseases: cardiovascular, lung cancer and infection

Abstract

Tobacco smoking is the biggest cause of lung cancer (LC) but continued smoking probably independently worsens outcomes.Aims:1. To assess the prevalence of smoking in people attending a rapid access clinic for suspected LC, given the changing demographics of UK smokers and introduction public smoking bans.2. To see if smoking status is associated with traditional adverse prognostic indicators for LC.As part of a larger trial we report on the first 415 attenders who were subsequently diagnosed with LC. Anyone who admitted to smoking within 7 days or who had an exhaled carbon monoxide >10 parts per million were deemed smokers. Patients also completed a baseline quality of life questionnaire (EQ5D) and WHO performance status.41% of attenders with LC were smoking at the time of their LC diagnosis.

Table to compare smokers and non-smokers (ex or never)

Variable Mean (SD)	Non-smokers (N=244)	Smokers (N=171)	p-value
Age yrs	69.4 (9.6)	65.5 (10.0)	0.005
TNM Stage	3.12 (0.98)	3.20 (0.92)	0.496
Tumour staging	2.45 (1.13)	2.83 (1.20)	0.024
WHO Performance Status	1.00 (0.84)	1.20 (0.89)	0.026
Total EQ5D	7.58 (2.19)	7.91 (1.97)	0.140

At the time of LC diagnosis current smokers were significantly younger yet had larger tumours and worse performance status. The larger tunour size may reflect delays in presentation or that nicotine accelerates tumour growth.¹The lower performance status probably also reflects more co-morbidity (e.g. COPD/ cardiac dysfunction etc) as there was no significant difference in TNM cancer stage.Data collection continues to compare clinical outcomes and responses to treatment in smokers and non-smokers.1. Hecht, S.S. (1999). Tobacco smoke carcinogens and lung cancer. JNCI J Natl Cancer Inst,91 (14), 1194-1210.

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Citations should be made in the following way:
R. Roberts, K. Lewis (LLanelli, Swansea, United Kingdom). Comparing smokers and non-smokers attending a rapid access lung cancer clinic. Eur Respir J 2014; 44: Suppl. 58, 327

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