Not only cigarettes – other culprits of lung cancer
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Chair and Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland
Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University, Lublin, Poland
Anna Grzywa-Celińska   

Chair and Department of Pneumonology, Oncology and Allergology, Medical University , Lublin.
Introduction. Before cigarettes became popular, lung cancer was an extremely rare disease, but currently it is the most common cause worldwide of cancer death in both genders. Therefore, it constitutes a huge epidemiological, diagnostic and socio-economic challenge around the world. In Poland, lung cancer is the second most common carcinoma in both men and women, and it is also the most prevailing cause of carcinous death. Undoubtedly, although smoking classical cigarettes is the strongest risk factor of developing the cancer, unfortunately it is not the only one. Objective. The aim of this study was to present smoking-related factors, e.g. cigars, pipes, e-cigarettes or marijuana smoking, etiologically related to lung cancer incidence.
Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med. 2011; 32(4): 605–644.
Ochsner A. Corner of history: my first recognition of the relationship of smoking and lung cancer. Prev Med. 1973; 2: 611–614.
Adler I. Primary malignant growths of the lungs and bronchi. New York: Longmans, Green, and Company, 1912.
Hruby AJ, Sweany HC. Primary carcinoma of the lung: with special reference to incidence, early diagnosis and treatment. Arch Intern Med. 1933; 52(4): 497–540.
American Cancer Society; Key Statistics for Lung Cancer 2018;
Zatoński W, Zatoński M, Janik-Koncewicz K, Połtyn-Zaradna K, Wijatkowska K, Marciniak A. Hundred years of cigarette smoking in Poland: three phases of the tobacco epidemic. J Health Inequal. 2017; 3(2): 118–122. doi:10.5114/jhi.2017.74200.
Trząsalska A, Staszyńska M, Krassowska U. Raport z ogólnopolskiego badania ankietowego na temat postaw wobec palenia tytoniu. [Report of polish nationwide survey on attitudes towards cigarette smoking].] (Polish).
U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014.
Wojciechowska U, Czaderny K, Ciuba A, Olasek P, Didkowska J. Cancer in Poland in 2016, Polish Ministry of Health, Warsaw 2018.
Czaderny K. Uwarunkowania skłonności do palenia papierosów. Wyniki modelowania równań strukturalnych [Conditioning of propensity to smoking cigarettes. The results of structural equations modeling]. Studia Demograficzne 2017; 171(1): 49–69 (Polish).
Krajowy Rejestr Nowotworów (KRN): Nowotwory złośliwe opłucnej i płuca (C33–34) [National Cancer Registry: Malignant Neoplasms of the Lung and Pleura (C33–34)]. (Polish).
Didkowska J, Wojciechowska U, Zatoński W. Prediction of cancer incidence and mortality in Poland up to the year 2025, Warsaw 2009.
Jassem J, Wysocki WM. Klasyfikacja TNM (2017) w niedrobnokomórkowym raku płuca [TNM classification (2017) in non-small cell lung carcinoma] 3.16–1 (Polish).
Ministerstwo Zdrowia: Leczenie niedrobnokomórkowego raka płuca [Polish Ministry of Health: Treatment of non-small cell lung cancer]. (Polish).
Crivellari G, Monfardini S, Stragliotto S, Marino D, Aversa SM. Increasing chemotherapy in small-cell lung cancer: from dose intensity and density to megadoses. Oncologist. 2007; 12(1): 79–89.
Hirsch FR, Scagliotti GV, Mulshine JL, Kwon R, Curran W, Wu YL, Paz-Ares L. Lung cancer: current therapies and new targeted treatments Lancet. 2016; 389(10066): 299–311. doi: 10.1016/S0140-6736(16)30958-8.
Ministerstwo Zdrowia: Leczenie niedrobnokomórkowego raka płuca z zastosowaniem afatynibu i nintedanibu [Polish Ministry of Health: Treatment of non-small cell lung cancer with afatynib and nintedanib]. (Polish).
Pearl R Tobacco smoking and longevity. Science. 1938; 87(2253): 216–217. doi: 10.1126/science.87.2253.216.
Doll R, Hill AB. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950; 2(4682): 739–748.
Doll R. Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors. Br Med J. 1956; 2(5001): 1071–1081.
Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service, U.S. Department of Health, Education, and Welfare, 1964,
Wynder EL, Graham EA. Etiologic factors in bronchiogenic carcinoma with special reference to industrial exposures; report of eight hundred fifty-seven proved cases. AMA Arch Ind Hyg Occup Med. 1951; 4(3): 221–235.
Lickint F. Bronchial carcinoma in non-smokers. Munch Med Wochen-schr. 1954; 96(47): 1366–1369 (German).
Ochsner A, DeBakey M. Carcinoma of the lung. Arch Surg. 1941; 42(2): 209–258.
Ochsner A, Debakey M. Primary pulmonary malignancy: treatment by total pneumonectomy; analysis of 79 collected cases and presentation of 7 personal cases. Ochsner J. 1999; 1(3): 109–125.
International Agency for Research on Cancer; IARC Monographs on the Identification of Carcinogenic Hazards to humans;
Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328 (7455): 1519. doi: 10.1136/bmj.38142.554479.AE.
Baker F, Ainsworth SR, Dye JT, Crammer C, Thun MJ, Hoffmann D et al. Health risks associated with cigar smoking. JAMA. 2000; 284(6): 735–740.
National Cancer Institute; Cigar Smoking and Cancer;
Boffetta P, Pershagen G, Jöckel KH, Forastiere F, Gaborieau V, Heinrich J et al. Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe. J Natl Cancer Inst. 1999; 91(8): 697–701.
Lubin JH, Richter BS, Blot WJ. Lung cancer risk with cigar and pipe use. J Natl Cancer Instit. 1984; 73(2): 377–381.
Carstensen JM, Pershagen G, Eklund G. Mortality in relation to cigarette and pipe smoking: 16 years’ observation of 25 000 Swedish men. J Epidemiol Commumity Health; 1987; 41: 166–172.
Damber LA, Larsson LG. Smoking and lung cancer with special regard to type of smoking and type of cancer. A case-control study in north Sweden. Br J Cancer. 1986; 53(5): 673–681.
Główny Urząd Statystyczny, Zdrowie i zachowanie zdrowotne mieszkańców Polski w świetle Europejskiego Ankietowego Badania Zdrowia (EHIS) 2014 r. [Central Statistical Office of Poland, Health and health behaviour of inhabitants of Poland in the light of European Interview Health Survey (EHIS)], Warszawa, 1 grudnia 2015.
European Monitoring Centre for Drugs and Drug Addiction (2017), Poland, Country Drug Report 2017, Publications Office of the European Union, Luxembourg.
Denissenko MF, Pao A, Tang M, Pfeifer GP. Preferential formation of benz[a]pyrene adducts at lung cancer mutational hotspots in P53. Science. 1996; 274: 430–432.
Barsky SH, Roth MD, Kleerup EC, Simmons M, Tashkin DP. Histopathologic and molecular alterations in bronchial epithelium in habitual smokers of marijuana, cocaine, and/or tobacco. J Natl Cancer Inst. 1998; 90(16): 1198–1205.
Melamede R. Cannabis and tobacco smoke are not equally carcinogenic. Harm Reduct J. 2005; 18(2): 21.
Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC Text with EEA relevance.[Dyrektywa Parlamentu Europejskiego i Rady 2014/40/UE z dnia 3 kwietnia 2014 r. w sprawie zbliżenia przepisów ustawowych, wykonawczych i administracyjnych państw członkowskich w sprawie produkcji, prezentowania i sprzedaży wyrobów tytoniowych i powiązanych wyrobów oraz uchylająca dyrektywę 2001/37/WE] content/PL/TXT/?uri=celex%3A32014L0040] (polish).
Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014; 23(2): 133–139. doi: 10.1136/tobaccocontrol-2012-050859.
Murray RP, Connett JE, Zapawa LM. Does nicotine replacement therapy cause cancer? Evidence from the Lung Health Study. Nicotine Tob Res. 2009; 11(9): 1076–1082. doi: 10.1093/ntr/ntp104.