Effective prevention of smoking among teenagers narrows racial disparity in lung cancer rates

Effective prevention of smoking among teenagers, particularly black teenagers, is narrowing the disparity in lung cancer rates between blacks and whites, according to a report published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. The December issue has a special focus on tobacco.

Although researchers are focusing a lot of attention on lung cancers that are not linked to smoking, the vast majority of lung cancers in the United States are directly attributable to smoking patterns, which gives urgency to anti-smoking campaigns.

"This report is good news in that it shows the importance of preventing teens from smoking in narrowing or eliminating racial disparities in smoking-related diseases," said Ahmedin Jemal, D.V.M., Ph.D., strategic director for cancer occurrence at the American Cancer Society. "The potential for eliminating racial or socioeconomic disparities from other lifestyle related diseases, such as heart disease linked to obesity, is profound."

Lung cancer rates have been consistently higher in blacks than whites at all ages, and at younger ages in women. However, anti-smoking efforts among teenagers have had marked effectiveness since the 1970s, so Jemal and colleagues sought to confirm the relationship between decreased smoking and decreased lung cancer. They used the mortality data from the CDC's National Center for Health Statistics and the incidence data from the National Cancer Institute's Surveillance Epidemiology and End Results Program.

From 1992 through 2006, lung cancer death rates among men decreased by 7.9 percent per year in blacks and 3.6 percent per year in whites. For women, the death rates decreased by 4.8 percent per year in blacks compared to 1.9 percent per year in whites.

As a result, among men, the increased risk of death from lung cancer among blacks compared with whites decreased from more than 200 percent in 1992 to just 28 percent in 2006. Among black women compared with white women, there was a 47 percent increased risk of death in 1992 that had all but disappeared by 2006.

The gap in incidence rates closed as well. In 1992, black men were more than twice as likely to get lung cancer, but only 30 percent more likely by 2006. Among women, the risk dropped from 75 percent greater in 1992 to 22 percent greater by 2006.

"This should be encouraging to anyone who is trying to develop a public health message against lifestyle factors we know are modifiable; the results are definitely real," said Jemal.