Impact of postdiagnosis smoking on long-term survival of cancer patients: the Shanghai cohort study.
Impact of postdiagnosis smoking on long-term survival of cancer patients: the Shanghai cohort study.
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DOI：
10.1158/1055-9965.epi-13-0805-t
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发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Yuan JM
中科院分区：
文献类型：
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作者：
Tao L;Wang R;Gao YT;Yuan JM
癌症是中国男性的头号死因。吸烟是最可预防的癌症原因。关于癌症诊断后继续吸烟对癌症患者生存率影响的数据很少。我们研究了上海队列研究中1,632名癌症患者诊断后吸烟与全因死亡风险之间的关系，该队列研究是一项基于人群的前瞻性队列研究，共有18,244名上海男性参加。通过每年一次的面对面访谈确定基线访谈后吸烟状况的变化。使用考克斯比例风险回归模型估计与吸烟状态变化相关的全因死亡率的风险比（HR）和95%置信区间（CI）。与癌症诊断后不吸烟的癌症患者相比，癌症诊断后继续吸烟的患者的死亡风险增加了59%（95% CI = 36-86%），具有统计学意义。在癌症诊断时的吸烟者中，HR（95% CI）为1.79（1.49-2.16）在所有癌症患者中，2.36（1.63-3.42）肺癌患者，1.63胃癌组与确诊后戒烟组比较，差异有显著性（0.98-2.73），结直肠癌组差异有显著性（2.31 ~ 1.40 ~ 3.81），膀胱癌组差异有显著性（2.95 ~ 1.09）。诊断后吸烟显著增加了男性癌症患者的死亡风险。这些数据提供了关于吸烟和癌症生存的新信息，这将为未来的研究提供信息，这些研究可能会导致癌症患者在诊断后环境中对吸烟的关注不足。
Cancer is the number one cause of death among men in China. Cigarette smoking is the most preventable cause of cancer. Data on the impact of continued smoking after cancer diagnosis on survival of cancer patients are sparse. We studied the association between post-diagnosis smoking and risk of all-cause death among 1,632 incident cancer patients in the Shanghai Cohort Study, a population-based prospective cohort of 18,244 men in Shanghai. The change of smoking status after baseline interview was ascertained through annual in-person interviews. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality associated with change in smoking status. Patients who continued smoking after cancer diagnosis experienced a statistically significant 59% (95% CI = 36–86%) increase in risk of death compared with cancer patients who did not smoke after cancer diagnosis. Among current smokers at cancer diagnosis, HRs (95% CIs) were 1.79 (1.49–2.16) in all cancer patients, 2.36 (1.63–3.42) in lung cancer patients, 1.63 (0.98–2.73) in stomach cancer patients, 2.31 (1.40–3.81) in colorectal cancer patients, and 2.95 (1.09–7.95) in bladder cancer patients who continued smoking compared with their counterparts who stopped smoking after cancer diagnosis. Post-diagnosis cigarettes smoking significantly increased the risk of death for male cancer patients. These data provide new information regarding smoking and cancer survival, which should inform future research into the contextual and individual-level barriers that may result in inadequate attention of smoking among cancer patients in the post-diagnosis setting.