Every year Toronto is host to the Gairdner Awards
Many of the award winners are past or future Nobel prize winners (in Medicine).

The last two days of the program consist of free public lectures by past winners. The speakers and talks are in such high regard that my supervisor even cancels our regular Friday labmeeting to allow us to attend the Gairdners. Really, that’s saying something. This year’s theme is Cancer. Unfortunately, the Gairdners hit Toronto at the same time as a nasty cold virus, and I only just recovered enough to allow myself into a full lecture hall in time for the last talk, by Dr. Richard Peto of the Clinical Trial Service Unit & Epidemiological Studies Unit at the University of Oxford. He won the Gairdner Award in 1992.

A live-blogged summary of his talk on cancer mortality in relation to smoking is below. They’re notes, so the grammar is…non-existent.

Peto looks separately at deaths at 0-34 years old and deaths at 35-69(“middle age”).

world wide mortality in 2000: 60 million, equally divided over 0-34, 35-69, and older.
In age group 0-34 HIV accounts for a large number of deaths, and a graph shows both onset of disease and treatment. Childhood mortality rates in this age group goes down over time (since 1950s)

Future deaths among 130million BORN in 2000: most (70 mill) over 70, least 0-34 (20mill). 40 million in middle age. Of these, expected 10mill of cancer. Currently 4 mill (of 20) die of cancer in this age groups.

Cancer mortality: treatment and prevention
Childhood leukemia death rates go down steadily since 1970 when chemotherapy started. Same for total cancer mortality in 0-34 age group.
Middle age (35-69) most successful cancer treatment has been for breast cancer. Rates increase until 1990 and then go down: better treatment, earlier detection, etc.

Total cancer mortality:
male/female 0-34 low altogether
35-69 much higher, but lower in women than in men. Women: increase until late 80s, then down (breast cancer treatment improves). Male still higher, but also going down since about 1960.
Men higher than women: reason is smoking.

Cancer mortality trends attributed and not attributed to tobacco.
Men in UK: late’60s half of cancer deaths 35-69 caused by smoking. has gone down since then. In US trend is later: peaks in 80s. Poland even later: peaks in 90s, but is now also starting to go down.
Smoking related cancer deaths generate more peaks and dips than other cancers in these graphs: major cause. Still of course other factors than tobacco that also cause cancer: chronic infection in developing countries (HPV, HIV, EBV etc), occupational factors (asbestos, radon, etc), hormonal factors (HRT, kids (more kids = less cancer), obesity).

“If you want to kill yourself by smoking, you’ve got to start young AND keep smoking”
This is the case in the UK.
For women: UK and US started not until 1950s, so can’t say anything yet for old age effect.

UK study (men): smokers die 10 years earlier than non-smokers. After first study came out, people stopped smoking. Stopping at age 35-44 gained back about 9 years (almost no difference with non-smokers)
The million women study: risks of death/lung cancer plotted to number of cigs smoked a day: linear. 10 cig is 20x risk of lung cancer.

Stopping smoking: even stopping at age 50 reduces risk.

[at this point some graphs came by that just seemed to show the context of how many people die of smoking vs non-smoking. Summary: if nobody smoked, cancer rates would be MUCH lower. Decrease overall is result from people stopping smoking]

Graph: trends in cigarette consumption followed several years later by trends in lung cancer.

Cancer NOT attributed to smoking: gradually decreasing overall. Still going down slowly for women, plateaued since 70s for men. So the up/down trends are all smoking-related.
Scale stretched to see small differences: does go down for eg colorectal, prostate, breast cancers.

Control group: France. Did NOT stop smoking collectively (like UK/US) and lung cancer rates have been going UP in age group 35-44. (Graph looks like mirror image of rapid decline in the UK graph)

China: cigarette use increased about 40 years after US. Similarly, smoking related deaths are 40 years behind in China. (these numbers: men only)

US/EU: 1million new smokers a year. Half will be killed by tobacco if they don’t stop. SImilar risk in China/India.
Worldwide: 30 million new smokers a year. 50% of these men die, 10% of women [forgot why this is lower]
If current patterns continue, 1 billion people in the 21st century will die of tobacco use. People who die in first half of the century are already smoking now, but can still stop the half a billion deaths that will occur from 2050-2100 by reducing the number of children who take up smoking.

Website: Deaths From Smoking