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Background: For many patients with lung cancer, disease progression occurs without notice or with vague symptoms, and unfortunately, most treatments are not curative. Given this unpredictability, we hypothesized the following: (1) poorer psychological adjustment (specifically, more depressive symptoms, higher perceptions of stress, and poorer emotional well-being) would be associated with higher intolerance for uncertainty, higher perceived illness-related ambiguity, and their interaction; and (2) greater avoidance would mediate associations between higher intolerance of uncertainty and poorer psychological adjustment., Methods: Participants (N = 49) diagnosed with lung cancer at least 6 months prior to enrollment completed the Center for Epidemiologic Studies - Depression Scale, the Functional Assessment of Cancer Therapy - Lung Emotional Well-being subscale, the Perceived Stress scale, the Intolerance of Uncertainty scale, the Mishel Uncertainty in Illness Scale Ambiguity subscale, the Impact of Event - Revised Avoidance subscale, and the Short-scale Eysenck Personality Questionnaire - Revised Neuroticism subscale. Mean age was 64.2 years (standard deviation [SD] = 11.0), mean years of education was 15.6 (SD = 3.1), and 71.4% were female. Hypotheses were tested with regression analyses, adjusted for neuroticism., Results: Higher perceptions of stress and poorer emotional well-being were associated with higher levels of intolerance of uncertainty and higher perceived illness-related ambiguity. Non-somatic depressive symptoms were associated with higher levels of intolerance of uncertainty. Avoidance was found to mediate relations of intolerance of uncertainty with non-somatic depressive symptoms and emotional well-being only., Conclusions: Findings suggest that interventions to address avoidance and intolerance of uncertainty in individuals with lung cancer may help improve psychological adjustment., (Copyright © 2012 John Wiley & Sons, Ltd.)

Background: This study was designed to assess the prevalence of smoking at time of lung cancer diagnosis in a surgical patient cohort referred for cardiothoracic surgery., Methods: Retrospective study of lung cancer patients (n = 626) referred to three cardiothoracic surgeons at a tertiary care medical center in Southern California from January 2006 to December 2008. Relationships among years of smoking cessation, smoking status, and tumor histology were analyzed with Chi-square tests., Results: Seventy-seven percent (482) had a smoking history while 11.3% (71) were current smokers. The length of smoking cessation to cancer diagnosis was <1 year for 56 (13.6%), 1-10 years for 110 (26.8%), 11-20 years for 87 (21.2%), 21-30 years for 66 (16.1%), 31-40 years for 44 (10.7%), 41-50 years for 40 (9.7%) and 51-60 years for 8 (1.9%). The mean cessation was 18.1 ± 15.7 years (n = 411 former smokers). Fifty-nine percent had stage 1 disease and 68.0% had adenocarcinoma. Squamous cell carcinoma was more prevalent in smokers (15.6% vs. 8.3%, p = 0.028); adenocarcinoma was more prevalent in never-smokers (79.9% versus 64.3%, p = 0.0004). The prevalence of adenocarcinoma varied inversely with pack year (p < 0.0001) and directly with years of smoking cessation (p = 0.0005)., Conclusions: In a surgical lung cancer cohort, the majority of patients were smoking abstinent greater than one decade before the diagnosis of lung cancer.