Axial fused image (SUVmax, 2.2) of after RF ablation at FDG PET/CT. Image source: Deandreis et al. Radiology 2011; 258:270-276.

The rates of new lung cancer cases in the U.S. dropped among men in 35 states and among women in six states between 1999 and 2008, according to a report by the Centers for Disease Control and Prevention (CDC). Among women, lung cancer incidence decreased nationwide between 2006 and 2008, after increasing steadily for decades. Smoking cessation fueled the decline and other data have suggested CT screening could motivate smokers to quit.

The decrease in lung cancer cases corresponds closely with smoking patterns across the nation. In the West, where smoking prevalence is lower among men and women than in other regions, lung cancer incidence is decreasing faster. Studies show declines in lung cancer rates can be seen as soon as five years after smoking rates decline, according to the CDC.

The report also noted that states that make greater investments in effective tobacco control strategies see larger reductions in smoking; and the longer they invest, the greater the savings in smoking-related healthcare costs. Such strategies include higher tobacco prices, hard-hitting media campaigns, 100 percent smoke-free policies and easily accessible quitting treatments and services for those who want to quit.

“Although lung cancer among men and women has decreased over the past few years, too many people continue to get sick and die from lung cancers, most of which are caused by smoking. The more we invest in proven tobacco control efforts, the fewer people will die from lung cancer,” said CDC Director Thomas R. Frieden, MD, MPH, in a statement.

For this report, researchers analyzed lung cancer data from CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. They estimated smoking behavior by state using the CDC's Behavioral Risk Factor Surveillance System.

Study findings include:

• Among men, lung cancer rates continued to decrease nationwide.
• From 1999 to 2008, lung cancer rates among men decreased in 35 states and remained stable in nine states (change could not be assessed in six states and the District of Columbia).
• States with the lowest lung cancer incidence among men were clustered in the West.
• After increasing for years, lung cancer rates among women decreased nationwide between 2006 and 2008.
• Lung cancer rates decreased between 1999 and 2008 among women in California, Florida, Nevada, Oregon, Texas and Washington.
• Lung cancer rates among women remained stable in 24 states, and increased slightly in 14 states (change could not be assessed in six states and Washington, D.C.).

With tobacco control efforts linked to declines in lung cancer, it may be possible for screening CT to play a role.

A recent debate in the Annals of Internal Medicine linked screening and smoking cessation. It noted that screening provides a “teachable moment,” a point reinforced by the one-year quit rate of 12 to 20 percent among smokers in screening trials vs. the 4 percent background quit rate among smokers.