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There are Many things that cause lung cancer other than smoking. Infact majority of people that smoke don't get Cancer (only about 30% in a group of smokers ge

by max_ 2y ago

There are Many things that cause lung cancer other than smoking. Infact majority of people that smoke don't get Cancer (only about 30% in a group of smokers get lung cancer) Edit: I don't mean it's comforting I prefer to have it at 0/10 I am just trying to say that things that cause cancer are not as deterministic as we think.

rafram 2y ago
"If you smoke, your chances of getting cancer are only 3 in 10!" is not actually very comforting.
- max_ 2y ago
  I don't mean it's comforting I prefer to have it at 0/10. I am just trying to say that things that cause cancer are not as deterministic as we think.
  - panabee 2y ago
    this is correct. it's clear that smoking elevates cancer risk, but why doesn't it cause cancer in all smokers? to develop a cure, we must better understand the causal mechanisms. this starts with acknowledging what we know and don't know about a devilishly complex disease that is arguably better conceptualized as a broad category rather than one monolith -- similar to how the flu, cold, and covid could be grouped under one mega classification, but are better identified as distinct conditions.
    - s1artibartfast 2y ago
      I think we understand the causal mechanism pretty well. it is just laypeople struggle with binary thinking vs probability. The reason why only 20% of smokers get cancer is similar to why a person doesn't get cancer after 1 cigarette. This is only counterintuitive if your default thinking is that smoking=cancer. In reality, there are a lot of variable chemical and biological processes involved, but ultimately it ultimately boils down to a cumulative risk, not guarantee.
      - pokerface_86 2y ago
        [dead]
- jejeyyy77 2y ago
  20% of lung cancer cases in the US are people who have never smoked.
  - hackeraccount 2y ago
    Poor Stephen Jay Gould. :-(
- d1sxeyes 2y ago
  Also worth remembering that cancer isn’t the only bad thing smoking does to you. 7/10 smokers (2/3) die of a smoking related illness.
  - jjgreen 2y ago
    Any idea of what percentage of non-smokers die of a smoking related illness?
    - d1sxeyes 2y ago
      Short answer: no. Longer answer: Logically, the answer should be zero, but it's actually not that simple to categorise either 'non-smokers' or 'a smoking-related illness'. Taking lung cancer as an example, approximately 10-20% of lung cancers occur in folks who are non-smokers (defined as 'never' or 'fewer than 100 cigarettes in their lifetime'). Researchers estimate that of these, around 20% are caused by second hand smoking, meaning that around 8-16% of lung cancers are non 'smoking related' in non-smokers. Not all lung cancers result in death. So if we take the same approach, and consider the 80% of lung cancers which occur in smokers, presumably similarly 10-20% of those would have developed lung cancer regardless of whether they smoked or not, so potentially we would need to say that less than 65% of lung cancers are caused by smoking. Is it then fair to call lung cancer a 'smoking-related illness', if more than a third of people who develop lung cancer did not do so because they themselves smoked[0] (the number changes to 70% if we consder the folks who hypothetically develop lung cancer due to second-hand smoking as 'smoking-related'). There are also a lot a problems with the methodology here. How do we know whether someone really smoked 100 cigarettes or fewer? Is there any statistically significant difference between people who smoked 100 and 1 000? 100 000? Does it matter if someone smoked all of those 10 000 in the last year (almost 30 a day) or whether they smoked those 10 000 over the past 50 years (less than a pack a month)? All of these things seem to my mind to be problematic and make it impossible to answer your question. I suppose that means that I was overconfident in my assertion in the parent comment that '7/10 smokers die of smoking-related illnesses'. It was not unresearched (although uncited) and I got this number from this article: https://www.washingtonpost.com/news/wonk/wp/2015/02/26/the-terrifying-rate-at-which-smokers-die-from-smoking/ https://www.washingtonpost.com/news/wonk/wp/2015/02/26/the-t..., which in turn reported on this study: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0281-z https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291.... However, perhaps I wasn't critical enough in my reading, and instead simply parroted the stat. [0]: big caveat here is that my ramblings don't consider the possibility that a 50 year-old who would otherwise have developed lung cancer at 80 develops lung cancer as a result of smoking, and lung cancers caused by smoking stop lung cancers developing from other causes.
nneonneo 2y ago
I mean, it’s not going to be 0/10 because smoking causes cancer. Cancer itself isn’t deterministic. This isn’t news. There is virtually nothing that is 100% guaranteed to produce cancer, but there are things that massively increase risk. Tobacco is one of them. An estimated 72% of lung cancers in Canada are caused by tobacco (https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/legislation/tobacco-product-labelling/smoking-lung-cancer.html https://www.canada.ca/en/health-canada/services/health-conce...) Smokers are 25x more likely to die of lung cancer as nonsmokers. The US CDC estimates that smoking is linked to 80-90% of lung cancer deaths (https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm). Saying “tobacco causes lung cancer” isn’t guaranteeing that smoking leads to lung cancer, but it sure as hell is the leading cause.
- max_ 2y ago
  It is true that Tobacco increases cancer risk. But what about stuff like the use of Teflon and other "forever" chemicals? These things may also be making a contribution. It could also be a genetic defect. A liver cell growing in the lung. Or maybe a staple food familiar to Asian women that is being contaminated with carcinogens.
da_chicken 2y ago
Yes, but as far as risk factors for lung cancer, second-hand smoking is one of the better known. I don't immediately see Asian American women being exposed to additional regional air pollution, asbestos, coal soot, or radon more than others. There could be a race-linked genetic factor, but I'm not aware of Asian women that are non-American having a higher rate. So I don't see why it would be something like... aspirated cooking oils fumes or natural gas fumes while cooking. Do Asian American households have a significantly higher likelihood of natural gas stoves? Do they have cultural histories of certain kinds of make-up or body treatments like talc?
- samatman 2y ago
  > as far as risk factors for lung cancer, second-hand smoking is one of the better known. The risk is real and measurable, but to put that in perspective: the CDC summary says it increases risk by 20-30%, so 130% over baseline to take the higher number https://www.cdc.gov/tobacco/secondhand-smoke/health.html https://www.cdc.gov/tobacco/secondhand-smoke/health.html For smokers, the risk is 15-30 times baseline, so 3000% over baseline for the high end https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm The article indicates a 260% increased all-factor risk for never-smoking Asian women, compared to White women. There has to be more going on than just second-hand smoke exposure.
DonsDiscountGas 2y ago
IIRC the lifetime risk of lung cancer for smokers is more like 20%. For reference, among non-smokers the risk of lung cancer[0] is about 1%. So smoking is represents a 20x increase in risk. Around 80% of lung cancers are found in smokers and another 10% with heavy exposure to second-hand smoke. Smoking is the single largest risk factor for lung cancer. [0] All numbers are based on general population of US, so heavily white-skewed, I dunno about asian americans specifically.
Zancarius 2y ago
I suspect part of this is because smokers, generally, don't always live long enough to actually get cancer, and statistically their year-over-year cancer risk drops to the same as the general population when they do quit. However, COPD, once established, is irreversible. My dad was a long time smoker and it was COPD that eventually got him. He battled it for years after he quit.
drewcoo 2y ago
> There are Many things that cause lung cancer other than smoking. Radon is the #2 cause of lung cancer in the US. There are high levels of radon in about 1/15 US homes. https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm

by max_ 2y ago

rafram 2y ago

"If you smoke, your chances of getting cancer are only 3 in 10!" is not actually very comforting.

max_ 2y ago
I don't mean it's comforting I prefer to have it at 0/10. I am just trying to say that things that cause cancer are not as deterministic as we think.
- panabee 2y ago
  this is correct. it's clear that smoking elevates cancer risk, but why doesn't it cause cancer in all smokers? to develop a cure, we must better understand the causal mechanisms. this starts with acknowledging what we know and don't know about a devilishly complex disease that is arguably better conceptualized as a broad category rather than one monolith -- similar to how the flu, cold, and covid could be grouped under one mega classification, but are better identified as distinct conditions.
  - s1artibartfast 2y ago
    I think we understand the causal mechanism pretty well. it is just laypeople struggle with binary thinking vs probability. The reason why only 20% of smokers get cancer is similar to why a person doesn't get cancer after 1 cigarette. This is only counterintuitive if your default thinking is that smoking=cancer. In reality, there are a lot of variable chemical and biological processes involved, but ultimately it ultimately boils down to a cumulative risk, not guarantee.
    - pokerface_86 2y ago
      [dead]
jejeyyy77 2y ago
20% of lung cancer cases in the US are people who have never smoked.
- hackeraccount 2y ago
  Poor Stephen Jay Gould. :-(
d1sxeyes 2y ago
Also worth remembering that cancer isn’t the only bad thing smoking does to you. 7/10 smokers (2/3) die of a smoking related illness.
- jjgreen 2y ago
  Any idea of what percentage of non-smokers die of a smoking related illness?
  - d1sxeyes 2y ago
    Short answer: no. Longer answer: Logically, the answer should be zero, but it's actually not that simple to categorise either 'non-smokers' or 'a smoking-related illness'. Taking lung cancer as an example, approximately 10-20% of lung cancers occur in folks who are non-smokers (defined as 'never' or 'fewer than 100 cigarettes in their lifetime'). Researchers estimate that of these, around 20% are caused by second hand smoking, meaning that around 8-16% of lung cancers are non 'smoking related' in non-smokers. Not all lung cancers result in death. So if we take the same approach, and consider the 80% of lung cancers which occur in smokers, presumably similarly 10-20% of those would have developed lung cancer regardless of whether they smoked or not, so potentially we would need to say that less than 65% of lung cancers are caused by smoking. Is it then fair to call lung cancer a 'smoking-related illness', if more than a third of people who develop lung cancer did not do so because they themselves smoked[0] (the number changes to 70% if we consder the folks who hypothetically develop lung cancer due to second-hand smoking as 'smoking-related'). There are also a lot a problems with the methodology here. How do we know whether someone really smoked 100 cigarettes or fewer? Is there any statistically significant difference between people who smoked 100 and 1 000? 100 000? Does it matter if someone smoked all of those 10 000 in the last year (almost 30 a day) or whether they smoked those 10 000 over the past 50 years (less than a pack a month)? All of these things seem to my mind to be problematic and make it impossible to answer your question. I suppose that means that I was overconfident in my assertion in the parent comment that '7/10 smokers die of smoking-related illnesses'. It was not unresearched (although uncited) and I got this number from this article: https://www.washingtonpost.com/news/wonk/wp/2015/02/26/the-terrifying-rate-at-which-smokers-die-from-smoking/ https://www.washingtonpost.com/news/wonk/wp/2015/02/26/the-t..., which in turn reported on this study: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0281-z https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291.... However, perhaps I wasn't critical enough in my reading, and instead simply parroted the stat. [0]: big caveat here is that my ramblings don't consider the possibility that a 50 year-old who would otherwise have developed lung cancer at 80 develops lung cancer as a result of smoking, and lung cancers caused by smoking stop lung cancers developing from other causes.

nneonneo 2y ago

I mean, it’s not going to be 0/10 because smoking causes cancer. Cancer itself isn’t deterministic. This isn’t news. There is virtually nothing that is 100% guaranteed to produce cancer, but there are things that massively increase risk. Tobacco is one of them. An estimated 72% of lung cancers in Canada are caused by tobacco (https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/legislation/tobacco-product-labelling/smoking-lung-cancer.html https://www.canada.ca/en/health-canada/services/health-conce...) Smokers are 25x more likely to die of lung cancer as nonsmokers. The US CDC estimates that smoking is linked to 80-90% of lung cancer deaths (https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm). Saying “tobacco causes lung cancer” isn’t guaranteeing that smoking leads to lung cancer, but it sure as hell is the leading cause.

max_ 2y ago
It is true that Tobacco increases cancer risk. But what about stuff like the use of Teflon and other "forever" chemicals? These things may also be making a contribution. It could also be a genetic defect. A liver cell growing in the lung. Or maybe a staple food familiar to Asian women that is being contaminated with carcinogens.

da_chicken 2y ago

Yes, but as far as risk factors for lung cancer, second-hand smoking is one of the better known. I don't immediately see Asian American women being exposed to additional regional air pollution, asbestos, coal soot, or radon more than others. There could be a race-linked genetic factor, but I'm not aware of Asian women that are non-American having a higher rate. So I don't see why it would be something like... aspirated cooking oils fumes or natural gas fumes while cooking. Do Asian American households have a significantly higher likelihood of natural gas stoves? Do they have cultural histories of certain kinds of make-up or body treatments like talc?

samatman 2y ago
> as far as risk factors for lung cancer, second-hand smoking is one of the better known. The risk is real and measurable, but to put that in perspective: the CDC summary says it increases risk by 20-30%, so 130% over baseline to take the higher number https://www.cdc.gov/tobacco/secondhand-smoke/health.html https://www.cdc.gov/tobacco/secondhand-smoke/health.html For smokers, the risk is 15-30 times baseline, so 3000% over baseline for the high end https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm The article indicates a 260% increased all-factor risk for never-smoking Asian women, compared to White women. There has to be more going on than just second-hand smoke exposure.

DonsDiscountGas 2y ago

IIRC the lifetime risk of lung cancer for smokers is more like 20%. For reference, among non-smokers the risk of lung cancer[0] is about 1%. So smoking is represents a 20x increase in risk. Around 80% of lung cancers are found in smokers and another 10% with heavy exposure to second-hand smoke. Smoking is the single largest risk factor for lung cancer. [0] All numbers are based on general population of US, so heavily white-skewed, I dunno about asian americans specifically.

Zancarius 2y ago

I suspect part of this is because smokers, generally, don't always live long enough to actually get cancer, and statistically their year-over-year cancer risk drops to the same as the general population when they do quit. However, COPD, once established, is irreversible. My dad was a long time smoker and it was COPD that eventually got him. He battled it for years after he quit.

drewcoo 2y ago

> There are Many things that cause lung cancer other than smoking. Radon is the #2 cause of lung cancer in the US. There are high levels of radon in about 1/15 US homes. https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm