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Lung Cancer Prognosis Better for Non-Smokers Than Smokers

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NEW YORK JUL 18, 2007 (Reuters Health) - Cigarette smokers who develop non-small-cell lung cancer (NSCLC) have a less favorable outlook than do their counterparts who have never smoked, researchers report in the July issue of Chest.

As Dr. Robert James Cerfolio told Reuters Health, "smoking cigarettes is the main cause of lung cancer. In this prospective study, we found that not only is it the main cause of NSCLC, but the more you have smoked the worse your prognosis."

Dr. Cerfolio and Dr. Ayesha Bryant at the University of Alabama, Birmingham, note that the impact of smoking cigarettes on survival after a diagnosis of lung cancer is disputed.

To investigate further, the researchers studied data on 730 patients with NSCLC. This had been prospectively gathered over a 6-year period. In total, 562 subjects were smokers and 168 had never smoked.

Never smokers were more likely to be younger, to be women and to be symptomatic at the time of presentation.

The overall 5-year survival rate was significantly higher in never-smokers (64%) than it was in smokers (56%).

This was also true of stage-specific 5-year survival. For stage I disease, this was 75% versus 62%; for stage II, it was 53% versus 46%; and for stage III, it was 41% versus 36%.

In addition, the 5-year survival rate was significantly lower in patients who had a smoking history of more than 20 pack-years.

The researchers note that the findings need to be corroborated, but suggest that because smokers with stage I and stage II disease "have a worse prognosis than those who never smoked," perhaps they should be "more aggressively treated and/or more frequently followed up after undergoing resection

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