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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Influence of Type of Cigarette on Peripheral versus Central Lung Cancer

Daniel R. Brooks, John H.M. Austin, Robert T. Heelan, Michelle S. Ginsberg, Victor Shin, Sara H. Olson, Joshua E. Muscat and Steven D. Stellman
Daniel R. Brooks
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John H.M. Austin
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Robert T. Heelan
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Michelle S. Ginsberg
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Victor Shin
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Sara H. Olson
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Joshua E. Muscat
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Steven D. Stellman
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DOI: 10.1158/1055-9965.EPI-04-0468 Published March 2005
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Abstract

Objectives: Adenocarcinoma has replaced squamous cell carcinoma as the most common cell type of lung cancer in the United States. It has been proposed that this shift is due to the increased use of filter and lower-tar cigarettes, resulting in increased delivery of smoke to peripheral regions of the lungs, where adenocarcinoma usually occurs. We reviewed radiologic data to evaluate the hypothesis that tumors in smokers of cigarettes with lower-tar yield are more likely to occur peripherally than tumors in smokers of higher-yield cigarettes.

Methods: At two urban academic medical centers, we reviewed computed tomographic scans, chest radiographs, and medical records to assign tumor location (peripheral or central) for 330 smokers diagnosed with carcinoma of the lung between 1993 and 1999. We compared the proportion of tumors in a peripheral versus central location by lifetime filter use and average lifetime tar rating (<21 and ≥21 mg).

Results: Tumor location (69% peripheral and 31% central) was unrelated to cigarette filter use. Smokers of cigarettes with lower-tar ratings were more likely than those with higher ratings to have peripheral rather than central tumors (odds ratio, 1.76; 95% confidence interval, 0.89-3.47). When restricted to subjects with adenocarcinoma or squamous cell carcinoma, the odds ratio (95% confidence interval) was 2.31 (1.05-5.08).

Conclusions: Among cigarette smokers with lung cancer, use of cigarettes with lower-tar yield was associated with preferential occurrence of tumors in peripheral sites. Our findings support the hypothesis that changes in smoking associated with lower-tar cigarettes have led to a shift in the location of smoking-related lung cancer.

  • Lung cancer
  • Tobacco
  • CT scans
  • Epidemiology

Footnotes

  • Grant support: USPHS grants CA-68384 and CA-17613.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted October 27, 2004.
    • Received June 22, 2004.
    • Revision received October 19, 2004.
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Cancer Epidemiology Biomarkers & Prevention: 14 (3)
March 2005
Volume 14, Issue 3
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Influence of Type of Cigarette on Peripheral versus Central Lung Cancer
Daniel R. Brooks, John H.M. Austin, Robert T. Heelan, Michelle S. Ginsberg, Victor Shin, Sara H. Olson, Joshua E. Muscat and Steven D. Stellman
Cancer Epidemiol Biomarkers Prev March 1 2005 (14) (3) 576-581; DOI: 10.1158/1055-9965.EPI-04-0468

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Influence of Type of Cigarette on Peripheral versus Central Lung Cancer
Daniel R. Brooks, John H.M. Austin, Robert T. Heelan, Michelle S. Ginsberg, Victor Shin, Sara H. Olson, Joshua E. Muscat and Steven D. Stellman
Cancer Epidemiol Biomarkers Prev March 1 2005 (14) (3) 576-581; DOI: 10.1158/1055-9965.EPI-04-0468
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