title: The impact of a negative history of smoking on survival in patients with non-small cell lung cancer detected with clinic-based screening programs.
abstract: OBJECTIVE
  The aim of this study was to determine the epidemiological characteristics of never-smoking patients with non-small cell lung cancer (NSCLC) detected with clinic-based screening programs, focusing on clinical risk factors and survival.
  
  
  METHODS
  The medical records of NSCLC patients (n=285) diagnosed at Fujisawa City Hospital between April 2000 and December 2010 with lesions that were originally detected with clinic-based screening programs in Fujisawa City were reviewed to identify the clinicopathological variables and survival outcomes.
  
  
  RESULTS
  Of the 285 NSCLC patients, 95 (33.3%) were never-smokers. A comparison between the never-smoking and ever-smoking patients revealed that the never-smokers included a significantly greater proportion of women and patients with adenocarcinoma (86.3% vs. 12.6%: p<0.001 or 94.7% vs. 55.8%: p<0.001, respectively). The overall survival rate of the never-smoking patients was significantly superior to that of the ever-smokers (p=0.004). In addition to smoking status, factors found to be significantly associated with the overall survival rate in univariate analyses were gender, stage, histology and first line treatment. A multivariate analysis revealed smoking status to be an independent prognostic factor in addition to stage and first line treatment.
  
  
  CONCLUSIONS
  The differences in the clinicopathological factors and survival outcomes between never-smoking and ever-smoking patients with NSCLC detected with clinic-based screening programs suggest that persuading people to never start smoking is important.
authors.affiliation: Department of Respiratory Medicine, Fujisawa City Hospital, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nagakura
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Nobuko
authors.initials: N
authors.lastname: Kusano
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011379:Prognosis; D012727:Sex Characteristics; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology