UICC World Cancer Congress 2006

Objective: Tobacco control and cancer treatment disparities and their relationships to cancer death rate disparities globally were nearly unquantified until recently. We will highlight revealing new assessments of smoke exposure and cancer death rate disparities locally to globally, smoke overload/cancer death rate associations, smoking/cancer associations in Asia, and the lack of control for smoke exposure disparities in clinical trial recruitment and outcome assessment.

Methods: Local to global smoke exposure and cancer death rate assessments, novel smoke overload/cancer death rate time-series, cohort, and cross-sectional associations, cohort and other studies in Asians, and systematic reviews will be presented.

Results: Very large smoke exposure and cancer death rate disparities exist between regions and nations globally and between places, races, and other strata within nations. The cancer disparities are strongly associated with smoke exposure, especially newer, better proxies for cumulative tobacco smoke overexposure (smoke overload), with a few exceptions. The findings suggest that most non-stomach non-uterus cancer treatments in the United States and globally through 2002 were likely no more life-saving than lung cancer treatments.

Limitations of previous studies could be contributing to the likely ineffectiveness of many cancer treatments to date. Cancer treatment clinical trials (RCT) have seldom controlled for initial smoking status, let alone reliably and comprehensively measured intra-trial smoke exposure. RCT seldom have included anything better than convenience sample, often likely relatively lightly smoke exposed, subjects.