The importance of incorporating smoking cessation into lung cancer screening

Lung cancer is the leading cause of cancer-related death in the United States (U.S.) and it is the most common non-skin cancer affecting both men and women, accounting for an estimated 235,000 new cases in 2018 and about 30% of cancer-related deaths (1). Not surprisingly, cancer patients with smoking-related disease have the highest prevalence of smoking at diagnosis. Among patients with lung or head and neck tumors, smoking prevalence is 40–60% (2-5) and data indicate that 39% of patients with any smoking-related cancer (other than lung cancer) are current smokers (6). Some estimates suggest that up to 50% of patients either do not quit after diagnosis, or relapse following initial quit attempts (2). There is a causal relationship between continued cigarette smoking and all-cause and cancer-specific mortality, higher risk of progression, and increased risk for tobacco-related second primary cancers in cancer patients and survivors (7)