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C. Tsai
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P3.05 - Poster Session/ Prevention and Tobacco Control (ID 217)
- Event: WCLC 2015
- Type: Poster
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.05-006 - Tobacco Control and the Trend of Lung Cancer Histology in Taiwan, 1994-2011 (ID 1471)
09:30 - 09:30 | Author(s): C. Tsai
- Abstract
Background:
Tobacco control policies in Taiwan have resulted in substantial declines in smoking prevalence and cigarette consumption. The ingredients of cigarettes have changed under government regulations. The changing epidemiology of lung cancer has also been observed in recent years. In this study, the lung cancer incidence and trend of histological types after the initiation of tobacco control policies were evaluated.
Methods:
We examined the data from Taiwan Cancer Registry to evaluate lung cancer incidence rates and frequencies of different histological type. The information of tobacco control and smoking prevalence from Health Promotion Administration and Food and Drug Administration in Taiwan were analyzed to identify the relation between tobacco control and lung cancer trend.
Results:
In total, 135073 individuals were diagnosed with lung cancer from 1994 to 2011 in Taiwan. The age-standardized incidence rate (ASIR) of all lung cancer patients increased significantly (22.3 per 10[5] in 1994 to 34.04 in 2011), and the average annual percentage change (AAPC) was 2.6 [95% confidence interval (CI): 2-3.2, p < 0.0001]. The ASIR of female lung cancer patients (13.82 per 10[5] in 1994 to 24.79 in 2011, AAPC 3.6, 95% CI: 2.8-4.5, p < 0.001) rose more rapidly than that of male patients (30.11 per 10[5] in 1994 to 44.21 in 2011, AAPC 2.4, 95% CI: 1.8-3, p < 0.0001). Adult (≥18y/o) and male smoking prevalence decreased gradually (29.1% in 1994 to 19.1% in 2011, 54.8% to 33.5%, respectively) after the initiation of Tobacco Hazards Prevention Act in 1997. In addition, tobacco health welfare surcharge was gradually increased by the government, and adult smoking prevalence also decreased at the same time. However, female smoking prevalence remained relatively low level during the study period (3.3% in 1994 to 4.4% in 2011), so no obvious decline was observed. Therefore, decreased male smoking prevalence may contribute to the lower AAPC in male population than in females. The upper limit of tar and nicotine in each cigarette were gradually reduced under government regulations (tar: 15mg/cigarette in 2001 to 10 in 2009; nicotine: 1.5 mg/cigarette in 2001 to 1 in 2009), and there was a decline in average contents of tar and nicotine in each cigarette during study period. The increasing proportion of adenocarcinoma (45.5% in 1995 to 60.3% in 2011) and decreasing proportion of squamous cell carcinoma (SCC) (32.6% in 1995 to 19.1% in 2011) were observed during study period. The correlation coefficient (CC) between the content of tar per cigarette and proportion of SCC was 0.988 (p < 0.001). The CC between the content of nicotine per cigarette and proportion of adenocarcinoma was -0.942 (p < 0.001). The changes in the composition of cigarette may have influence on the trend of lung cancer histology.
Conclusion:
Tobacco control policies have led to reduction in adult smoking prevalence, but failed to decrease the overall lung cancer incidence. However, they may reduce the ascending rate of lung cancer incidence. The changing trend of lung cancer histology may be affected by the different composition of cigarettes.
