### Consensus consistency validation — 9 October 2026

**Current grade:** Θ  
**Grade changed:** no

**Scope:** Retrospective, transparently unblinded consistency check of load-bearing primary records already in the topic inventory. This is not a new peer review and does not establish historical Consensus use.

**Consensus queries:**
- `tobacco smoking causal lung cancer cohort case control cessation dose response mutational mechanism primary studies`
- `primary prospective British doctors smoking lung cancer Doll Peto 50 years 2004 cessation risk cohort original study`
- `Doll Peto Mortality in relation to smoking 50 years observations on male British doctors 2004 BMJ original paper`

**Saved raw Consensus records:**
- `D:\HypothesisCritic\deliverables\consensus_consistency_audit_2026-10-09\checks\smoking-lung-carcinoma\consensus-search-01.json`
- `D:\HypothesisCritic\deliverables\consensus_consistency_audit_2026-10-09\checks\smoking-lung-carcinoma\consensus-search-02.json`
- `D:\HypothesisCritic\deliverables\consensus_consistency_audit_2026-10-09\checks\smoking-lung-carcinoma\consensus-search-03.json`
- `D:\HypothesisCritic\deliverables\consensus_consistency_audit_2026-10-09\checks\smoking-lung-carcinoma\consensus-fetch-23f85c7fbe72578a91a1b00491caa2e4.json`

**Original-primary comparisons:**
- **PMID 14772469** (claims C1) (PubMed abstract_metadata in baseline inventory): Doll-Hill hospital-based case-control study reported a strong smoking/lung carcinoma association; early case-control design, later complemented by prospective evidence.
- **PMID 15213107** (claims C4,C5) (Full-text complete as documented by source inventory): Fifty-year British doctors cohort: cause-specific mortality varied with smoking; cessation at younger ages avoided much excess risk; prospective follow-up.
- **PMID 10926586** (claims C5) (Full-text complete as documented by source inventory): UK lung-cancer risk and cessation trends from national statistics and case-control studies; risk declines after stopping with latency.
- **PMID 8832894** (claims C8) (Full-text complete as documented by source inventory): Benzo[a]pyrene adducts preferentially form at lung-cancer p53 mutation hotspots; mechanism complements but does not alone quantify attributable fraction.

**Discovery/reconciliation versus source incorporation:** Broad query returned recent mutational-signature papers and reviews; targeted exact-title query retrieved Doll et al.'s 50-year British doctors cohort (PMID 15213107). Fetch of modern mechanism and second-primary-risk records; the original source ledger supports dose-response, cessation, and mutational lines. The existing phrase 'consensus and mechanistic reviews' is not tool documentation.

**Conclusion:** No grade change: Θ for sustained smoking as a major initiating cause of human lung carcinoma, with never-smoker cases bounding necessity and most smokers not developing the disease bounding sufficiency. Fresh search/fetch is retrospective, not historical service-use evidence.




This dated supplement adds source reconciliation to the original review. Its original narrative, registered scope, source inventory and grades remain historical records. No earlier adversarial approval has been verified for this edition at the supplement date. This provenance supplement has no separate approval and is not an independent or blinded adjudication. New sources described here are supplemental and are not counted in the original inventory.