Variations in the Risk of Getting Lung Cancer

To help smokers and former smokers decide whether to undergo lung scanning, a team of statisticians developed a decision-making tool to estimate an individual's risk of getting lung cancer within the next decade. Calculations show, for example, that a 68-year-old man who smoked two packs a day for 50 years has a one in seven chance of getting lung cancer in the next ten years. A 51-year-old woman who smoked one pack a day for 28 years before quitting nine years ago has a less than a one in a hundred chance of getting lung cancer during the next ten years.

A description of this new decision-making tool was published by Peter B. Bach, MD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York City, in a recent issue of the JNCI (Journal of the National Cancer Institute, 3/19/03). In the article entitled "Variations in Lung Cancer Risk Among Smokers," Dr. Bach and colleagues explained that their new risk prediction tool is based on data from a large lung cancer prevention trial, known by the acronym CARET, which followed smokers and former smokers to determine whether vitamin supplements had any impact on lung cancer incidence or mortality. People can go to the Memorial Sloan-Kettering Web site (see address at right) and answer six questions that will determine their lung cancer risk.

Dr. Bach, the lead author, was asked by e-mail why the questions are confined to people who smoked for more than 25 years. "We were limited to using risk factors that were present and measured among participants in CARET, such as age, cigarette smoking history, and asbestos exposure," he answered.

"Additionally, the risk prediction tool is only able to assess risk over the next ten years for individuals who are similar to the participants in CARET, meaning that they are between the ages of 50 and 75 and have smoked between 10 and 60 cigarettes per day for between 25 and 55 years," Dr. Bach continued. "Unfortunately, we are unable to offer risk assessments for individuals who are concerned about their risk based on additional risk factors or who do not meet these criteria. You can find more information about the risk prediction tool in the "Frequently Asked Questions" section of the tool, on our web site (www.mskcc.org/predictiontools/lungcancer)."

There is good reason to carefully consider risk before deciding to undergo a lung scan. The technology is so new that it has yet to be proven lifesaving. Its considerable risks are outlined in last month's lead article in HealthFacts entitled "Should Smokers and Former Smokers get Lung Scans?"

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