The Risk of Smoking in Lung Cancer Survivors

Smokers face high risk of disease recurrence after completing treatment.

Lung cancer survivors face an elevated risk for recurrence of the disease if they are smokers, a recent study found.

The study, presented at the ATS 2015 International Conference, examined lung cancer survivors who had shown no further evidence of having lung cancer following the completion of treatment.

"We looked closely at risk factors that may help in predicting cancer recurrence in lung cancer survivors," said study lead author Samjot Dhillon, MD, in a press release. "What we learned is that patients with a history of lung cancer should have close long-term surveillance so their doctor can detect early on if the cancer is recurring or if there is another cancer developing."

The study evaluated 192 lung cancer survivors who received CT scans of the chest and autofluorescence bronchoscopy (AFB) for a mean duration of up to 8 and a half years. AFB shows premalignant and early malignant lesions in the central airways. CT scans are able to show large lymph nodes in the chest or nodules within the lungs that could be due to cancer.

The study also included data regarding major risk factors to determine if there was an association between the risks and cancer recurrence. Among these factors were smoking status and how many packs the patients smoke per year, prior cancers, respiratory disease, asbestos exposure, and a family history of lung cancer.

The results showed 38% of patients developed recurrent or additional lung cancer during the timeframe. An analysis of the significant factors that predict lung cancer recurrence suggest these factors were recurrence of another non-lung cancer, a nodule on a CT scan regardless of size or location, finding metaplasia on 3 AFB exams anywhere in the central airway, and smoking duration.

Furthermore, with every additional pack smoked per year, the risk of having lung cancer increased again by 1%.

The findings indicate lung cancer survivors need to be monitored closely by providers to evaluate whether the disease is recurring or if another is developing.

"Along with close medical surveillance for lung cancer recurrence, it is also important for patients to stop smoking as soon as possible since this is a known risk," Dr. Dhillon said. "Every additional pack per year of smoking is associated with further increased risk of cancer recurrence."