Gastric Cancer

Gastric Cancer Picture

Everyone always talks about smoking related diseases like lung cancer, COPD and hypertension. But smoking is related to tons of other diseases, like gastric cancer. The thinking is that carcinogens are ingested during the smoking process and contaminate or affect the GI tract. However, many believe that there is no relationship between the two. That gastric cancer is just "tough luck" for those who acquire it. But as usual, those people would be wrong.

A recent study from Cancer Causes and Control (CCC) tells us that current cigarette smokers actually do have an elevated hazard ratio for gastric cancer over their never smoker counterparts, in both men and women. This is also true across ethnic groups. The researchers looked at African-Americans, Japanese Americans, Latino Americans, Native Hawaiians, and caucasions. Former smokers also had a higher risk than did never smokers, but only in men. The risk was also higher in those with a larger pack year history of smoking (packs per day x years smoked).

So there you go, yet another smoking related disease uncovered. It still amazes me why someone would want to start smoking in the first place. The perceived idea behind initiation is always trumped by the later acquired disease patterns and risks.

Bidi Smoking and Cancer

Recently, bidi smoking has emerged as a novel way to smoke. The allure, much like with water pipes, is the exotic nature of this type of smoking. The bidi's are hand-rolled cigarettes and are immensely popular in South Asia and India. In addition, much like the water pipe, it is perceived in the west, as a safer alternative to the standard cigarette.

So with that in mind, we here at Unbiased found an article that addressed this question of whether bidi smoking is safer than conventional cigarettes. Cancer Causes and Control published "Association of tobacco habits, including bidi smoking, with overall and site-specific cancer incidence: results from the Mumbai cohort study" by Pednekar, et al. Their study looked at the relationship between bidis and other forms of tobacco use with cancer rates in a metropolitan developing country.

There results shouldn't really surprise any of this blog's readers. The oral cancer incidence with bidi smokers was 42% higher than in cigarette smokers. The increase was 69% for all respiratory and intrathoracic organs combined. The lung cancer rate increased by 35% and the larynx cancer rate increased by 112%.

Smokeless tobacco caused the usual smokeless tobacco cancers of the lip, digestive tract, pharynx, mouth, respiratory organs and intrathoracic organs. Nothing Earth-shattering here.

If anyone thinks there is a safe way to smoke or ingest tobacco, they're kind of fooling themselves. Listen, tobacco kills. I think we'd all agree with that statement. It doesn't matter how you roll it or how you suck on it, your risk for cancer is elevated the moment it touches your lips. Why be subject to the risk if you don't have to be. There are many stop smoking benefits available. You don't have to go very far to find them.

"Greed is Good", I mean "Health is Good"

The Journal of the National Cancer Institute recently had a study which looked specifically at non-Hispanic white men and women. Cook, et al, wanted to evaluate the impact of smoking and then smoking cessation on the risk of adenocarcinoma of the esophagus.

I wanted to write about this topic because of the story about Michael Douglas, the long time actor who has come out this last week to let the world know that he has Stage 4 throat cancer. The actor did quit smoking a couple of years ago, back in 2006, but was self-described as a heavy smoker prior to his quitting. I'm not sure what kind of cancer Mr. Douglas has, but I can make a bet that it is some how related to his previous smoking habit.

The study, Cigarette Smoking and Adenocarcinomas of the Esophagus and Esophagogastric Junction: A Pooled Analysis From the International BEACON Consortium, found a correlation between esophagus adenocarcinoma and smoking. They also found a very strong correlation between smoking and the risk for developing esophagogastric junction adenocarcinoma along with all adenocarcinomas.

In addition, there was a strong dose-response link betweek heaviness of smoking and outcome. This is based on a term we use called pack-years. Pack-years is a method healthcare professionals use to quantitate how heavy someone smokes. You take the number of packs per day they smoke on average and multiply by the number of years they smoked. So if someone smoked about 1 pack per day for 40 years then they have a (1 X 40 = 40) 40 pack-year history. This helps us compare smokers to other smokers, apples to apples as it were.

It is evident that the longer someone was smoke-free, the less risk for developing adenocarcinoma of the esophagus they had, after adjusting for pack-years. For example, current smokers had the highest risk (odds ratio of 0.82), while those who quit 10 years ago had a lower risk (odds ratio 0.71). These differences in risk were seen in both men and women.
 
This is yet another unbiased study which details that smoking is bad for you. I still marvel at people who think this stuff is all made up. Those folks are in some serious denial.