Smoking at diagnosis and survival in cancer patients

International Journal of Cancer, 05/07/2012

Warren GW et al. – Current smoking increased mortality risks in lung, head/neck, prostate, and leukemia in men and breast, ovary, uterus, and melanoma in women. Current smoking was not associated with any survival benefit in any disease site. Data using prospective structured smoking assessments demonstrate that current smoking increased long term OM and DSM. Standardized smoking assessment at diagnosis is an important variable for evaluating outcomes in cancer patients.

Methods

  • To assess the effect of smoking at diagnosis on survival, structured smoking assessments were obtained in a cohort of 5185 cancer patients within 30 days of a cancer diagnosis between 1982-98.
  • Hazard ratios (HR) or odds ratios (OR) were generated to analyze the effects of smoking at diagnosis on overall mortality (OM) and disease specific mortality (DSM) in a patient cohort from 13 disease sites containing at least 100 patients in each disease site.

Results

  • With a minimum of 12 years of follow-up, current smoking increased OM risk vs. recent quit (HR 1.17), former (HR 1.29), and never smokers (HR 1.38) in the overall cohort.
  • Current smoking increased DSM risk vs. former (HR 1.23) and never smokers (HR 1.18).
  • In disease sites with proportionately large (>20%) recent quit cohorts (lung, head/neck), current smoking increased OM and DSM risks as compared with recent quit.

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