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Where there's smoke, there's cancer

January 13, 2014

    Dan Diamond, Managing Editor

    "Fifty years ago, we declared war on smoking"—so read one headline in last week's Daily Briefing, discussing a landmark 1964 Surgeon General report that first warned smoking can be linked to cancer,

    Smoking rates have since fallen, a lot. More than 40% of adults smoked in 1964; today, it's less than 20%.

    Yet tobacco use remains high in parts of the country, and that helps explain certain spikes in cancer deaths, too. (As D.C.-based advocacy professional Josh Rovner reminded me recently.) Take a look at the smoking-cancer correlation in the maps below.

    "It’s clear that smoking causes cancer," the Oncology Roundtable's Lindsay Conway told me. "Smoking is most often associated with lung cancer, but it’s also a risk factor for developing other types of cancers" like breast "and tobacco use is linked to head and neck cancers, [too]." 

    Rovner pointed out that there's also considerable overlap between smoking, cancer, and poverty, too, and I asked Lindsay to go deeper on that connection.

    "My guess is that underserved populations are more likely to be exposed to environmental carcinogens," she mused. "They also have higher mortality rates from cancer because they’re less likely to be screened for cancers and so tend to be diagnosed late." (As she often does, Lindsay pointed me to resources to help providers launch screening programs.) And once diagnosed, many people in these populations also lack resources—whether time, cost, or transportation—to follow through on treatment, too.

    » More from Lindsay: What the new guidelines mean for lung screening programs

    Lindsay and I also talked a bit more about lung cancer—how the incidence rate for lung cancer is much higher in states with big populations of smokers, for example—and she closed on a note of caution. Don't jump to conclusions about a person's cancer, she warned, even if the overall map connecting tobacco and cancer can encourage simple connections.

    "Because of the strong association with smoking, [advocates worry] that lung cancer patients get less sympathy—and less funding," Lindsay pointed out. "So advocates spend a lot of time reminding people that while smoking causes lung cancer, many non-smokers develop lung cancer too."

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