Lecture 8: Lung Cancer and Smoking Flashcards
What types of lung cancer are there?
- Small cell
- Non small cell (~85%)
what are some types of non small cell lung cancer?
- adenocarcinoma
- squamous cell carcinoma
- large cell carcinoma
What does this diagram show about nz?
An age standardised (world) incidence rates of lung cancer in females of all ages.
in NZ and Australia the incidence rate is equal to or above 17.9 per 100,000 people.
what does this diagram show about nz?
age standardised (world) incidence rates of lung cancer in males of all ages.
compared to the rest of the world, men seem to have a smaller incidence rate, but looking at the numbers it is quite similar to females in NZ and Australia. (17.9-30.1 per 100,000 people)
what do these diagrams show?
diagram on left:
- age standardised incidence rate of lung cancer by sex:
- incidence rates are higher for males than females
diagram on right:
- age standardised incidence and mortality rates of lung cancer
- lung cancer has a high mortality rate. in most regions of world if you have it, there is a fair chance you will die from it.
what is this?
Lopez’s 4 stages of the tobacco epidemic
what does the first stage show?
- the beginning of the epidemic
- prevalence of smoking was less than 20%
- mainly men
- caused few deaths
what does the second stage show?
- rapid increase in male smoking prevalence
- peak of 40% to 80%
- start of the main increase in female smokers
- start of the main increase of mortality from smoking
what does the third stage show?
- downturn in smoking among men
- some convergence of male and female smoking prevalences
- mortality by smoking rose from under 10% to ~30% of all death (mostly in males)
what does the fourth stage show?
- prevalence was decreases for males and females
- deaths related to smoking continued to rise
what does this show?
similar patterns to the lopez model
- in 1950, global male deaths from lung cancer increased rapidly, female deaths from lung cancer increased at a much slower rates
- by 1960’s, male deaths by lung cancer began to decline, while female death rates from lung cancer continued to decrease, but was consistently lower than male rates.
what can we see in this diagram?
- Both Maori and non-Maori incidence is lung cancer have reduced since 1996
- Maori rates are still significantly higher than non-Maori
what are some causes of lung cancer?
- smoking (90% in high income countries)
- occupational exposure to dusts, chemicals
- air pollution (outdoor and indoor)
- genes rarely play a part
What sort of study is best for cancer studies and why?
Cohort Study!
- because there is a long period of lag between exposure and outcome
- we can also look at multiple outcomes
- with a different study, it would be difficult to find all the outcomes of smoking.
what does this show?
those who stopped smoking at 25-34 had a higher percentage of survival, which became similar to that of non-smokers, from age 35 compared to cigarette smokers
those who stoped smoking at 55-64 had a higher chance of survival from age 60 compared to smokers, but the survival chance was not as high as non-smokers.
what does this show?
adult per capita cigarette consumption and major smoking health events in the US, 1900-2012
we can see that smoking increased after the US entered WW1 and the great depression began. it was not until the 1964 surgeon generals report on smoking and health did the rates start going down.
what is the prevalence of smoking in NZ?
current smokers (has smoked more than 100 cigarettes in lifetime and currently smokes at least once a month) NZ health survey shows:
the prevalence of current smoking in NZ health survey:
- this chart present unadjusted results and represents the actual percentages of the population affected in each time period
the smoking prevalence has decreased since 2011/12 to 2020/21
what are the smoking habits of different ethnic/age groups in NZ?
as of 2020/21 data:
- men smoked more than women
- maori more than non-maori
- pacific more than non-pacific
- non-asian more than asian
- least deprived more than most deprived
- non disabled adults more than disabled adults
prevalence was highest in 25-34 age group, but 18-24, 35-44, 45-54 were also high
15-17, 65-74 and 75+ were lower
how have the smoking habits changed in NZ from 1998-2022?
smoking rates in year 10 students in NZ have gone down since 1990-2022, but since 2015, vaping rates have increased
what is the prevalence of daily smoking by ethnicity?
While rates have decreassed for maori, pacific, asian and Nz european ethnicities from 1999-2021, Maori continue to have the highest prevalence of daily smoking, followed by pacific, then asian and NZ european having the lowest daily smoking prevalence.
