Smoking and survival among Kentucky women diagnosed with invasive cervical cancer: 1995-2005

Objectives. To determine whether smokers with cervical cancer were more likely to die from cervical cancer compared with non smokers after adjusting for confounding factors. Methods. A population-based survival analysis was conducted among 2661 women diagnosed with invasive cervical cancer and reported to the Kentucky Cancer Registry from 1995-2005 and linked with state vital records and the National Death Index through 12/31/2005. A standard Kaplan - Meier approach was used in this Survival analysis and Cox Proportional Hazards modeling was used to estimate adjusted hazard [aHR] ratios and 95% confidence intervals [CI] for smoking and survival for all cause and cervical cancer specific cause of death. Results. Almost half of women diagnosed with cervical cancer (48.6%) were known to be Current smokers based the medical record review and reporting to KCR. For another 19.4% no tobacco status was documented (missing) and 32.1% were known non smokers, After adjustment for age and stage at diagnosis, cell type, rural residence, race, insurance coverage, and treatment received, current smoker were 35% more likely to die of any cause (aHR=1.35: 95% CI=1.17-1.56) and 21% more likely to die of cervical cancer (aHR=1.21: 95% CI=1.01-1.46) compared with known non smoking cases. Conclusion. These data strongly suggest that smoking reduces cervical cancer survival. (C) 2008 Elsevier Inc. All rights reserved.