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Publications

Journal Article Ahead of print

PubMed: 42567897 DOI: 10.1038/s41416-026-03578-9

The effect of cigar, cigarillo and pipe smoking on lung cancer risk and screening eligibility.

Br J Cancer

Authors: Simran Vaja, Jennifer L Dickson, Carolyn Horst, Monica L Mullin, Amyn Bhamani, Andrew Creamer, Helen Hall, Chuen R Khaw, Ruth Prendecki, Priyam Verghese, Sophie Tisi, John McCabe, Esther Arthur-Darwka, Neal Navani, Anand Devaraj, Arjun Nair, Sam M Janes, Allan Hackshaw

Affiliations

  • Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
  • West Suffolk Hospital Foundation Trust, Bury St Edmunds, UK.
  • Lungs For Living, UCL Respiratory, Department of Medicine, University College London, London, UK.
  • King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK.
  • Division of Respiratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Imperial College Healthcare NHS Trust, London, UK.
  • Epsom and St Helier Hospitals NHS Trust, Epsom, UK.
  • University College London Hospitals NHS Foundation Trust, London, UK.
  • Mid and South Essex NHS Foundation Trust, Basildon, UK.
  • National Heart and Lung Institute, Imperial College, London, UK.
  • Royal Brompton and Harefield Hospitals, London, UK.
  • Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.

Abstract

BACKGROUND

Smokers are eligible for lung cancer screening using low dose CT (LDCT) if they have a sufficiently high risk of lung cancer. In England, for example, people are eligible if their estimated risk using either of two validated models (PLCO m2012 and Liverpool Lung Project) exceeds a certain threshold. Risk is often estimated using only cigarette consumption (duration and number per day), yet many smokers also use other cancer-causing tobacco products.

METHODS

SUMMIT is a prospective cohort study of a LDCT screening service. We evaluated the impact of cigars, pipes, and cigarillos on lung cancer risk.

RESULTS

Among 13,000 participants who were current/former cigarette smokers, 511 (1 in 25) were also regular users of cigars, pipes, or cigarillos. The 5-year cumulative lung cancer incidence in people who currently smoked both types of tobacco products was 8.85%, versus 5.74% for cigarette only current smokers. Among these 511 participants, the percentage whose risk was below the screening eligibility threshold ignoring other tobacco products which then exceeded the threshold including these products was 0.6% using LLPv2, and 8.2% using PLCO m2012.

CONCLUSIONS

All tobacco consumption should be considered when determining screening eligibility to avoid missing those who can benefit from LDCT.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov no: NCT03934866.

MeSH

Lung, Smokers, Neoplasms, Lung Neoplasms, Smoking, Pipe Smoking, Tobacco Products