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在从未吸烟过的肺癌幸存者中,第二个主要的肺癌

Eunji Choi¹, Chloe C Su^1,2, Julie T Wu³

¹Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California.

JAMA network open

|November 15, 2023

概括

从未吸烟过的肺癌幸存者面临着患第二次原发性肺癌 (SPLC) 的高风险,与吸烟者相似. 这凸显了对从不吸烟者有针对性的监控策略的必要性.

科学领域:

在瘤学瘤学.
流行病学流行病学
公共卫生公共卫生

背景情况:

从未吸烟者的肺癌占美国病例的25%.
改善初始原发性肺癌 (IPLC) 的存活率增加了第二次原发性肺癌 (SPLC) 的风险.
随着吸烟率的下降,需要对从未吸烟者中SPLC风险进行更密切的检查.

研究的目的:

估计和比较从未吸烟的肺癌幸存者的SPLC累积发病率与那些曾经吸烟的人.
在初始初级肺癌诊断后,分析SPLC与吸烟史相关的风险.

主要方法:

基于人口的前性队列研究,使用1993-2017年多民族队列研究 (MEC) 的数据.
通过监测,流行病学和最终结果 (SEER) 登记处对初始原发性肺癌 (IPLC) 和第二次原发性肺癌 (SPLC) 的跟踪.
对10年累积发病率和标准化发病率比率 (SIR) 的分析,按吸烟史分层 (从未吸烟者与经常吸烟者).

主要成果:

在长期吸烟者 (2.40%) 中,IPLC的10年累积发病率明显高于从未吸烟者 (0.34%).
然而,在IPLC之后的SPLC的10年累积发病率在从未吸烟者 (2.84%) 和一直吸烟者 (2.72%) 之间是相似的.
对SPLC的标准化发病率 (SIR) 在从未吸烟者中 (14.50) 与经常吸烟者 (3.50) 相比显著更高.

结论:

二次原发性肺癌 (SPLC) 的风险在从未吸烟的肺癌幸存者中与那些曾经吸烟的人一样高.
极其需要在从不吸烟者中确定SPLC的特定风险因素.
开发针对性监测策略对于有肺癌史的从未吸烟者至关重要.

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