Smokers at 54.5 times higher risk of SCLC than non-smokers

30-year smokers have a 54.5 times higher risk of developing small cell lung cancer than non-smokers

National Health Insurance Service releases study on cancer risk caused by smoking

A study has found that 30-year smokers have a 54.5 times higher risk of developing small cell lung cancer than non-smokers.

 

The National Health Insurance Service (NHIS) Health Insurance Policy Research Institute announced on the 11th the results of a comparative analysis of cancer incidence risk and attributable risk by cancer type among individuals with the same level of polygenic risk score (PRS) and similar living environments, focusing on major cancers with high incidence rates in Korea.

 

The study found that the risk of developing small cell lung cancer among current smokers (30 years or more, 20 pack-years or more) was 54.5 times higher than that of non-smokers, significantly higher than colorectal cancer (1.5 times), liver cancer (2.3 times), and stomach cancer (2.4 times higher).

 

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Cancer risk according to smoking history (hazard ratio)

This study was jointly conducted by the Health Insurance Policy Research Institute (Director Seongin Jeong) and Yonsei University Graduate School of Public Health (Professor Seon-ha Ji's research team).

 

The study analyzed data from 136,965 participants who underwent health screenings at 18 private screening centers nationwide from 2004 to 2013, linking health screening results, polygenic risk scores (PRS), central cancer registry data, and health insurance eligibility data, and followed the participants until 2020.

 

The analysis of cancer incidence risk showed that even when general characteristics, living environments, and PRS were at the same level, the incidence risk of smoking-related cancers (small cell lung cancer, squamous cell lung cancer, and squamous cell laryngeal cancer) was higher in the smoker group than that of other cancers.

 

Compared to non-smokers, current smokers with a smoking history of “30 years or more and 20 pack-years or more” had a significantly higher cancer incidence risk: 54.5 times higher for small cell lung cancer, 21.4 times higher for squamous cell lung cancer, and 8.3 times higher for squamous cell laryngeal cancer.

 

However, the risks were 2.4 times higher for stomach cancer, 2.3 times higher for liver cancer, and 1.5 times higher for colorectal cancer.

 

The extent to which smoking contributes to the development of small cell lung cancer was found to be 98.2%, followed by 88.0% for squamous cell laryngeal cancer, and 86.2% for squamous cell lung cancer, confirming that smoking is the primary cause of the cancers targeted in the tobacco litigation.

 

In contrast, the extent to which smoking contributes to the development of colorectal cancer is 28.6%, stomach cancer 50.8%, and liver cancer 57.2%, indicating that smoking contributes significantly less to these types of cancer compared to the cancers subject to litigation, and that other factors play a major role.

 

Genetic factors contribute only 0.4% to the development of squamous cell lung cancer, whereas they account for 7.3% of colorectal cancer and 5.1% of stomach cancer, indicating that genetic factors have a significantly greater influence on these cancers compared to squamous cell lung cancer, with respective differences of 18.3 times and 12.8 times.

 

Sunmi Lee, Director of the Health Insurance Policy Research Division at the Health Insurance Policy Research Institute, emphasized, “The results of this study show that smoking contributes significantly more to the development of lung cancer and laryngeal cancer compared to other types of cancer, while genetic factors play an extremely minor role.

 

This further clarifies the causal relationship between smoking and the development of lung cancer and laryngeal cancer.”