title: High prevalence of lung cancer in a surgical cohort of lung cancer patients a decade after smoking cessation.
abstract: BACKGROUND
  This study was designed to assess the prevalence of smoking at time of lung cancer diagnosis in a surgical patient cohort referred for cardiothoracic surgery.
  
  
  METHODS
  Retrospective study of lung cancer patients (n = 626) referred to three cardiothoracic surgeons at a tertiary care medical center in Southern California from January 2006 to December 2008. Relationships among years of smoking cessation, smoking status, and tumor histology were analyzed with Chi-square tests.
  
  
  RESULTS
  Seventy-seven percent (482) had a smoking history while 11.3% (71) were current smokers. The length of smoking cessation to cancer diagnosis was <1 year for 56 (13.6%), 1-10 years for 110 (26.8%), 11-20 years for 87 (21.2%), 21-30 years for 66 (16.1%), 31-40 years for 44 (10.7%), 41-50 years for 40 (9.7%) and 51-60 years for 8 (1.9%). The mean cessation was 18.1 ± 15.7 years (n = 411 former smokers). Fifty-nine percent had stage 1 disease and 68.0% had adenocarcinoma. Squamous cell carcinoma was more prevalent in smokers (15.6% vs. 8.3%, p = 0.028); adenocarcinoma was more prevalent in never-smokers (79.9% versus 64.3%, p = 0.0004). The prevalence of adenocarcinoma varied inversely with pack year (p < 0.0001) and directly with years of smoking cessation (p = 0.0005).
  
  
  CONCLUSIONS
  In a surgical lung cancer cohort, the majority of patients were smoking abstinent greater than one decade before the diagnosis of lung cancer.
authors.affiliation: Division of Hematology Oncology, UCLA David Geffen School of Medicine, 200 UCLA Medical Plaza, Suite 420 Los Angeles, CA 90024 USA. cindymongmd@gmail.com
authors.forename: Cindy
authors.initials: C
authors.lastname: Mong
authors.forename: Edward B
authors.initials: EB
authors.lastname: Garon
authors.forename: Clark
authors.initials: C
authors.lastname: Fuller
authors.forename: Ali
authors.initials: A
authors.lastname: Mahtabifard
authors.forename: James
authors.initials: J
authors.lastname: Mirocha
authors.forename: Zab
authors.initials: Z
authors.lastname: Mosenifar
authors.forename: Robert
authors.initials: R
authors.lastname: McKenna
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D011013:Pneumonectomy; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013997:Time Factors