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• W2198032235 abstract "In 1950, the association between cigarette smoking and lung cancer was firmly established. However, adenocarcinoma of the lung comprised only about 5% of lung cancers at the time and appeared unrelated to smoking. In the 1960s and 1970s, incidence of adenocarcinoma increased sharply, and became strongly related to smoking. SEER data on 307,797 lung cancer patients diagnosed in the US between 1975 and 2003 were analyzed. The objective was to assess changes in age-standardized incidence rates (per 100,000 population) at diagnosis of the four major lung cancer histologies: adenocarcinoma, squamous cell carcinoma, small cell carcinoma and large cell carcinoma. Incidence of each histologic subtype was measured during six time periods (1975-1979, 1980-1984, 1985-1989, 1990-1994, 1995-1999, 2000-2003). Comparisons were drawn based upon gender, race, and age. Because SEER contains no data on cigarette smoking, other sources were utilized to correlate changing histology to time trends in smoking prevalence, the changing cigarette, and Tobacco Institute actions. Among all patients, adenocarcinoma surpassed squamous carcinoma by 1980-1984 to become the most common histologic subtype. The incidence of adenocarcinoma rose 62% between 1975-1979 and 1995-1999, but then fell 8% in 2000-2003. Squamous cell incidence peaked in 1980-1984 and dropped by 35% by 2000-2003. Adenocarcinoma surpassed squamous cell in 1985-1989 in men, while adenocarcinoma had already become the most common form of lung cancer in women by 1975-1979. Adenocarcinoma rose 38% in men from 1975-1979 to 1995-1999, while it doubled in women during this interval. Among whites, adenocarcinoma surpassed squamous carcinoma by 1980-1984, although this did not occur among blacks for another decade. Nonetheless, incidence rate of adenocarcinoma has consistently been significantly higher among black males than in other subgroups, while incidence of adenocarcinoma has been nearly identical among white and black women. Adenocarcinoma was already most common among patients <50 yrs of age by 1975-1979, while adenocarcinoma rapidly increased and surpassed squamous carcinoma in all other age groups by 1990-1994. By 2000-2003, adenocarcinoma comprised 47% of all lung cancers (42% in men; 52% in women; 59% in pts <50 yrs). Currently, adenocarcinoma is the most common histology in both sexes, races, and in all age groups. The dramatic rise of adenocarcinoma of the lung is consistent with the hypothesis that changes in cigarette design and composition were the major factors that were responsible for this rise. This increase has been most striking among women and younger persons. Trends in adenocarcinoma correlate with the wide-scale adoption by smokers of filtered and low tar cigarettes, and with increasing nitrosamine levels in cigarettes. While filtered cigarettes comprised only 1% of the market in 1950, their use rapidly increased to 64% in 1964 and 95% in 1986. Today 98% of cigarettes made in the US are filtered. Specifically, the use of filter vents in cigarette design likely played a substantial role in this rapid rise of adenocarcinoma of the lung. The use of filter vents reduces the resistance to draw allowing smokers to take bigger, deeper puffs thereby facilitating the delivery of smoke particles deep into the airways. These changes were introduced by the Tobacco Industry in response to mounting evidence that cigarette smoking caused other forms of lung cancer. These actions by the Tobacco Industry contributed to the development of an epidemic of smoking-related adenocarcinoma of the lung." @default.
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• W2198032235 date "2007-08-01" @default.
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• W2198032235 title "PRS-01: The epidemic of smoking-related adenocarcinoma of the lung: The role of the tobacco industry and filtered and low-tar cigarettes" @default.
• W2198032235 doi "https://doi.org/10.1097/01.jto.0000283086.33229.0d" @default.
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