While lung cancer in smokers and former smokers is the biggest cancer killer by far, lung cancer in people who have never smoked is -- by itself -- the sixth biggest cancer killer in the United States.
"Most people are not aware that lung cancer among non-smokers has such an enormous impact," said Lung Cancer Alliance President Laurie Fenton-Ambrose today. The heavy burden of lung cancer in non-smokers contradicts the common belief that lung cancer is a disease that strikes only smokers.
Whether non-smokers are being diagnosed with lung cancer at an increasing rate and whether that rate is higher in women than men is under debate. An American Cancer Society (ACS) study released earlier this week added fuel to that debate by claiming the rate is not increasing, and that men and women who have never smoked have similar rates of lung cancer.
"Our primary concern is real people," said Fenton-Ambrose. "The statistical debate over rates will continue to play out but we must not lose sight of the actual numbers of people -- smokers, former smokers and never smokers -- who are dying from this stigmatized and underfunded cancer."
According to National Cancer Institute (NCI) estimates, 161,840 people -- smokers, former smokers and non-smokers -- will die of lung cancer in the U.S. in 2008. That is more people than the combined total of the next four biggest cancer killers: colon cancer (49,960 deaths), breast cancer (40,930 deaths), pancreatic cancer (34,290 deaths) and prostate cancer (28,660).
The generally accepted estimate -- and the estimate used in the ACS paper -- is that never smokers account for 10% to 15% of all lung cancer deaths.
With the 15% number, 24,276 non-smokers will die in 2008, making non- smoking lung cancer the sixth largest cancer killer, ahead of leukemia (21,710 deaths), lymphoma (20,510 deaths), liver cancer (18,410 deaths) and ovarian cancer (15,520).
At the lower estimate of 10%, 16,189 non-smokers will die of lung cancer in 2008, making it the ninth most lethal cancer. (See attached table.)
LCA Board member, Deborah Morosini MD, the sister of Dana Reeve, a never smoker, whose death from lung cancer in 2006 brought public attention to the full impact of the disease, called the numbers on smoking-related and non- smoking-related lung cancers "staggering."
"With smoking-related lung cancer the most lethal cancer and with non- smoking related lung cancer the sixth highest or even the ninth highest, it is clear that we must make lung cancer a national public health priority," she said. "This is not an 'either or situation'," she said. "We must address lung cancer period."
In a press release on Monday, ACS claimed its study showed that "over the last 50 to 70 years, there has been no increase in lung cancer among people who have never smoked."
However, state and regional cancer registries, which monitor the occurrence of cancer cases throughout the United States, do not routinely collect information on patient smoking history. As a result, there remains a lack of clear evidence regarding trends in non-smoking-related cancers over the last several decades.