Smoking at the time of diagnosis and mortality in cancer patients: What benefit does the quitter gain?
Smoking at the time of diagnosis and mortality in cancer patients: What benefit does the quitter gain?
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DOI：
10.1002/ijc.30601
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发表时间：
2017-04
影响因子：
6.4
通讯作者：
T. Tabuchi;A. Goto;Yuri Ito;K. Fukui;I. Miyashiro;T. Shinozaki
中科院分区：
文献类型：
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作者：
T. Tabuchi;A. Goto;Yuri Ito;K. Fukui;I. Miyashiro;T. Shinozaki
很少有研究调查癌症患者诊断时的吸烟行为（特别是戒烟者）与死亡率之间的关系。我们的目的是检查癌症患者戒烟对全因死亡率的益处。在1985年至2009年期间诊断的30，658名符合条件的癌症患者，由日本的医院癌症登记处确定，随访长达10年。我们使用考克斯比例风险模型和协变量校正生存曲线评估了癌症诊断时的吸烟行为（尤其是近期戒烟者与当前吸烟者）与全因死亡率的相关性。与目前吸烟者相比，最近戒烟者的死亡风险估计降低了11%。根据调整后的生存曲线，近期戒烟者的中位生存时间为8.25年，而目前吸烟者的中位生存时间为7.18年，这表明中位生存者的绝对差异为1.07年。同样，与目前吸烟者相比，从未吸烟者和曾经吸烟者的死亡风险分别降低了18%和16%，分别增加了1.90年和1.77年。除了以前和从不吸烟者之外，最近戒烟者在癌症患者诊断后的10年日历期间的生存率始终高于当前吸烟者。由于最近戒烟者在吸烟持续时间方面可能与癌症诊断后不久戒烟的患者相似，后者可能能够降低死亡风险，这表明戒烟可能是癌症护理的一部分。
Few studies have examined the association between smoking behavior (especially quitters) at the time of diagnosis and mortality among cancer patients. Our objective was to examine the benefits of quitting on all‐cause mortality among cancer patients. 30,658 eligible cancer patients diagnosed between 1985 and 2009, identified by a hospital‐based cancer registry in Japan, were followed up for up to 10 years. We evaluated smoking behavior at cancer diagnosis (especially recent quitters vs. current smokers) in association with all‐cause mortality using Cox‐proportional hazards models and covariates‐adjusted survival curves. Risk of death was estimated to be reduced by 11% in recent quitters compared with current smokers. According to adjusted survival curves, median survival time was 8.25 years for recent quitters versus 7.18 years for current smokers, indicating an absolute difference of 1.07 year for a median survivor. Similarly, never and former smokers had 18% and 16% lower risk of death with 1.90 years and 1.77 years gained, respectively, compared with current smokers. In addition to former and never smokers, recent quitters showed consistently higher survival rates than current smokers during the 10‐year calendar period after diagnosis among cancer patients. Because recent quitters may be similar to patients who stop smoking shortly after cancer diagnosis in terms of smoking duration, the latter may be able to decrease their risk of death, suggesting that smoking cessation could be part of cancer care.