Transcript NEO-ML2- FINAL Resp Cancers

TOBACCO AND RESPIRATORY CANCERS
Mini Lecture 2
Module: Tobacco Effects and Neoplasia
Objectives of the Mini Lecture
GOAL OF MODULE: Provide students with knowledge about
the development of cancers in the body as a result of tobacco
use.
LEARNING OBJECTIVES:
Students will be able to:
• Understand the different carcinogens in cigarette smoke and
mechanism of carcinogenesis.
• Explain the mechanism by which smoking causes lung cancer.
• Appreciate how tobacco is a risk factor for digestive cancers
and urogenital cancer.
• Understand the importance of cessation with cancer diagnosis
and the adverse effects of smoking on cancer management.
Contents
Core Slides
Optional Slides
1. Which Cancers Occur at
a Higher Rate in
Smokers?
2. Smoking and Lung
Cancer
3. Tobacco and Asbestos
4. SHS and Lung Cancer
5. Smoking Reduction
Reduces Risk
6. Cessation and Lung
Cancer
1. Lung Cancer
Mechanism
CORE SLIDES
Tobacco and Respiratory Cancers
Mini-Lecture 2
Module: Tobacco Effects and Neoplasia
Which Cancers Occur at a
Higher Rate in Smokers?
Directly linked to the action of carcinogens in smoke:
• Bronchial cancer
• Oral cancer
• Cancer of the larynx
The incidence of the following cancers is increased
significantly in smokers:
• Cancer of the esophagus
• Cancer of the bladder
• Cancer of the cervix
• Cancer of the kidney
• Pancreatic cancer
1. Vineis et al. 2004
Smoking and Lung Cancer
• 30% of all cancer deaths and up to
90% of all lung cancer deaths are
attributable to cigarette smoking.1
• The development of lung cancer is
directly related to
• number of cigarettes smoked
• length of smoking history
• tar and nicotine content of the
cigarettes.
• Lung cancer is highest among
current smokers and lowest
among nonsmokers.2
1. Quit-Smoking-Stop.com 2011; 2. Tan et al. 2008
www.upstate.edu/cdb/grossanat/thoraxpath8.php
Tobacco and Asbestos
• Asbestos exposure is strongly
associated with lung cancer,
malignant pleural mesothelioma,
and pulmonary fibrosis.
• Lung cancer risk increased by as
much as 5 times.
• Tobacco smoke and asbestos
exposure act synergistically.1
http://www.bmj.com/cgi/content/full/313/7057/615/F28
1. Veys 1996
Secondhand Smoke
and Lung Cancer
Second hand smoke (SHS) is a risk factor for:
• Lung cancer
• Other respiratory diseases
• Cancer of pharynx and larynx
• Deaths from chronic obstructive pulmonary disease
or emphysema, particularly in ex-smokers.1
1. Vineis et al. 2005
Smoking Reduction Reduces Risk
• Among individuals who smoke 20 or more cigarettes
per day, smoking reduction by 50% significantly
reduces the risk of lung cancer.1
• Smoking cessation is beneficial at any age, with much
greater benefits in reducing lung cancer risk accruing
to those quitting at younger ages.2
• Whatever the age of the patient, doctors should
always advise smokers to quit.
1. Godtfredsen et al. 2005; 2.Halpern et al. 1993
Cessation and Lung Cancer
• The risk of lung cancer declines slowly after smoking
cessation, so the earlier the quit the better.
• Long-term follow-up studies show that the relative risk
of lung cancer remains high in the first 10 years after
cessation.1
1. Tan et al. 2008
OPTIONAL SLIDES
Tobacco and Respiratory Cancers
Mini-Lecture 2
Module: Tobacco Effects and Neoplasia
Lung Cancer Mechanism
1. Hecht 1999
The most important health message a doctor
can give to patients is to quit smoking.