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This is the first review of studies measuring the effects of continued smoking after a lung cancer diagnosis, suggesting that it may be worthwhile to offer smoking cessation treatments to patients with early-stage lung cancer. Worldwide, lung cancer is the most commonly diagnosed form of cancer. In the UK, it ranks second only to breast cancer, accounting for approximately 39,000 new cancer diagnoses annually. Smoking increases the risk of developing primary lung cancer; lifelong smokers have a 20-fold increased risk compared to non-smokers. However, it remains unclear whether quitting after a lung cancer diagnosis offers any benefit.

Researchers at the University of Birmingham analyzed the results of 10 studies that measured the impact of quitting smoking after a lung cancer diagnosis on prognosis. Differences in study design and quality were considered to minimize bias. They found that individuals who continued smoking after an early-stage lung cancer diagnosis had a significantly higher risk of death and a greater risk of tumor recurrence compared to those who quit at that time. Data suggested that most of the increased risk of death was due to cancer progression. Further analysis revealed a five-year survival rate of 63-70% among quitters compared to 29-33% among continuing smokers. In other words, about twice as many quitters would survive for five years compared to continuing smokers.

These findings support the theory that continued smoking affects the behavior of a lung tumor, say the authors. They also provide a strong case for offering smoking cessation treatment to patients with early-stage lung cancer. Further trials are needed to examine these questions, they conclude.

An accompanying editorial states that this study adds more evidence that it's never too late for people to stop, even when they have lung cancer.

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