Clinical Topics & News

Examining the No. 1 Preventable Cause of Cancer

Tobacco contains more than 70 identified carcinogens and has been linked directly to 12 types of cancer.


 

When tobacco and cancer are mentioned, many people automatically assume lung cancer. But the 70-plus carcinogens identified in tobacco smoke cause at least 12 types of cancer, according to a Vital Signs report, including cancers of the stomach, kidney and renal pelvis, urinary bladder, and cervix. “Smokeless” products such as chewing tobacco carry 28 identified carcinogens.

Related: Quitting Smoking During Substance Abuse Treatment

Researchers from the CDC and National Cancer Institute analyzed data from the U.S. Cancer Statistics 2004-2013 to assess incidence and death rates for cancers caused by tobacco use. During that time, the incidence of tobacco-related cancer went down 1.3% per year, and mortality dropped 1.6% each year. Tobacco-related cancer incidence declined significantly in 44 states. Rates were lowest in the West and dropped the slowest in the Midwest.

However, the burden remains high, the researchers note, and disparities persist among certain groups. For instance, the incidence of tobacco-related cancer rose with age: Two-fifths of deaths were among people aged ≥ 75 years. And the incidence of cancer and death rates were highest but decreased fastest among blacks.

Related: Impact of a Drop-in Group Medical Appointment on Tobacco Quit Rates

There’s no question that lung cancer remains the cancer most linked to smoking. Lung cancer accounted for about one-third of tobacco-related cancer cases and almost one-half of tobacco-related cancer deaths. Between 2009 and 2013, about 101,300 men and 65,700 women died each year of cancers attributable to cigarette smoking—most died of lung cancer. Exposure to secondhand smoke accounted for another 7,300 deaths by lung cancer among nonsmokers.

Roughly 6 million people may die prematurely of a tobacco-related cancer unless they can take advantage of more sustained, comprehensive, and evidence-based interventions, the researchers say. States that have invested in smoking prevention and control programs, they point out, have seen larger declines in youth and adult smoking, decreases in lung cancer, and reduced tobacco-related health care costs.

Related: CDC Media Campaign Helps Americans Quit Smoking

The researchers also emphasize the benefits of smoking-cessation counseling and treatment as well as screening for cervical, colorectal, and lung cancers, to help detect them at earlier more easily treatable stages. Vaccination against hepatitis B virus and human papillomavirus can prevent liver and cervix cancer, to which tobacco can contribute.

According to Vital Signs , the CDC funds 65 comprehensive cancer control programs to prevent cancer, increase access to early detection and care for tobacco-related cancers, help cancer survivors quit using tobacco, and improve cancer outcomes, especially in communities with higher tobacco-related rates of cancer and deaths. The CDC also urges health care providers to encourage patients to quit—or not start—smoking, to be aware of screenings, and to remember that there’s no “risk-free” level of secondhand smoke.

Source:
Henley SJ, Thomas CC, Sharapova SR, et al. MMWR. 2016;65(44):1212-1218.

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