Researchers at the H. Lee Moffitt Cancer Center & Research Institute tested this idea: Because lung cancers in people who have never smoked arise without the cancer-causing effects of tobacco, their cancers might therefore display a different or disparate tumor biology. Those tumors might also behave in distinct ways, and survival rates of patients, compared with mortality from lung cancers occurring in smokers, might also be different.

Their findings, reported in the August issue of Chest, show that "lung cancer in never-smokers is a different disease in itself, with its own unique biology, behavior characteristics and survival rates," according to George R. Simon, M.D., (Assistant Professor of Medicine and Oncology, H Lee Moffitt Cancer Center and Research Institute)

An analysis of 522 smokers and 132 patients who had never smoked showed that the latter group's survival rate was indeed better. (Individuals in the "never-smoking" category tend to be older, predominantly female and to survive longer compared with the group of smokers.) The authors suggest that never-smokers have been spared direct assault from the 55 known carcinogens in tobacco smoke; hence "an alternate mechanism of cancer formation and therefore a distinct natural history and tumor biology" may exist.

Understanding these distinctions, and the underlying molecular biology, could lead to better prognostication, according to Simon. More important, these differences in biology could be exploited for therapeutic benefit and development of cohort-specific treatment strategies, which could in turn lead to many lives saved or extended.

In the accompanying editorial to the article, researchers from the Cleveland Clinic confirmed the relevance of the Moffitt study's findings and suggested clinical trials involving lung cancers be stratified by smoking vs. nonsmoking status.

In 2001, the National Cancer Institute awarded Moffitt the status of a Comprehensive Cancer Center in recognition of its excellence in research and contributions to clinical trials, prevention and cancer control. Additionally, Moffitt is a member of the National Comprehensive Cancer Network, a prestigious alliance of the country's leading cancer centers, and is listed in the U.S. News & World Report as one of the top cancer hospitals in America. Moffitt's sole mission is to contribute to the prevention and cure of cancer.