Assessment model based on medical history gauges lung cancer risk

HOUSTON - Clinicians may be one step closer to having a critical tool in identifying which smokers are at higher risk for developing lung cancer, the deadliest of all cancers, thanks to an assessment model generated by researchers at The University of Texas M. D. Anderson Cancer Center.

The prediction tool detailed in the May 2 issue of the Journal of the National Cancer Institute is the first designed to assign a score assessing a person's risk for the disease. It is also the first to use standard clinical and epidemiological data easily gathered by healthcare professionals, including: smoking habit; exposure to environmental tobacco smoke; family history of cancer; hay fever; emphysema; and exposure to dust, or asbestos.

"Our goal is to develop an instrument that can provide physicians with patients' estimated risk for developing lung cancer, like the Gail model does for breast cancer, or the Framingham model to predict heart disease," says Carol Etzel, Ph.D., assistant professor in the Department of Epidemiology, and the study's senior author.

The model's prediction level of lung cancer is about 60 percent. While modest, it's on par with that of the Gail model, say the researchers.

One might question the need for a lung cancer risk model since smoking is the primary cause of 85 percent of all lung cancers, says Margaret Spitz, M.D., professor and chair of the Department of Epidemiology and the study's lead author.

However, surprisingly, in life-time heavy smokers, less than 20 percent will actually develop lung cancer. "The challenge becomes how to identify that fraction of long-term cigarette smokers at the highest risk for the disease," she says.

"If we know who is at greatest risk for lung cancer, we can offer the most intense smoking cessation, or perhaps even offer chemo-preventive interventions. More importantly, we could intensively screen this population with modalities that might not be appr

Contact: Laura Sussman
University of Texas M. D. Anderson Cancer Center

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