Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies

被引：9

作者：

Alwers, Elizabeth ^{[1
]}

Carr, Prudence R. ^{[1
]}

Banbury, Barbara ^{[2
]}

Walter, Viola ^{[1
]}

Chang-Claude, Jenny ^{[3
,4
]}

Jansen, Lina ^{[1
]}

Drew, David A. ^{[5
,6
,7
]}

Giovannucci, Edward ^{[6
,8
,9
,10
]}

Nan, Hongmei ^{[11
]}

Berndt, Sonja, I ^{[12
]}

Huang, Wen-Yi ^{[12
]}

Prizment, Anna ^{[13
]}

Hayes, Richard B. ^{[14
]}

Sakoda, Lori C. ^{[15
]}

White, Emily ^{[2
]}

Labadie, Julia ^{[2
,16
]}

Slattery, Martha ^{[17
]}

Schoen, Robert E. ^{[18
]}

Diergaarde, Brenda ^{[19
,20
]}

van Guelpen, Bethany ^{[21
,22
]}

Campbell, Peter T. ^{[23
]}

Peters, Ulrike ^{[2
,16
]}

Chan, Andrew T. ^{[5
,6
,7
,8
,24
]}

Newcomb, Polly A. ^{[2
]}

Hoffmeister, Michael ^{[1
]}

Brenner, Hermann ^{[1
,25
,26
]}

机构：

[1] German Canc Res Ctr, Div Clin Epidemiol & Aging Res, Neuenheimer Feld 581, D-69120 Heidelberg, Germany

[2] Fred Hutchinson Canc Res Ctr, Publ Hlth Sci Div, 1124 Columbia St, Seattle, WA 98104 USA

[3] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[4] Univ Med Ctr Hamburg Eppendorf, Univ Canc Ctr Hamburg, Genet Tumor Epidemiol Grp, Hamburg, Germany

[5] Massachusetts Gen Hosp, Clin & Translat Epidemiol Unit, Boston, MA 02114 USA

[6] Harvard Med Sch, Boston, MA 02115 USA

[7] Massachusetts Gen Hosp, Div Gastroenterol, Boston, MA 02114 USA

[8] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[9] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA

[10] Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA

[11] Richard M Fairbanks Sch Publ Hlth, Dept Global Hlth, Indianapolis, IN USA

[12] NCI, Div Canc Epidemiol & Genet, NIH, Bethesda, MD 20892 USA

[13] Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[14] NYU, Dept Populat Hlth, Div Epidemiol, Sch Med, New York, NY USA

[15] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[16] Univ Washington, Dept Epidemiol, Sch Publ Hlth, Seattle, WA 98195 USA

[17] Univ Utah, Dept Internal Med, Salt Lake City, UT 84112 USA

[18] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA

[19] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Human Genet, Pittsburgh, PA 15261 USA

[20] UPMC Hillman Canc Ctr, Pittsburgh, PA USA

[21] Umea Univ, Dept Radiat Sci, Oncol Unit, Umea, Sweden

[22] Umea Univ, Wallenberg Ctr Mol Med, Umea, Sweden

[23] Amer Canc Soc, Dept Populat Sci, Atlanta, GA 30329 USA

[24] Broad Inst Harvard & MIT, Cambridge, MA USA

[25] German Canc Res Ctr, Div Prevent Oncol, Heidelberg, Germany

[26] German Canc Res Ctr, German Canc Consortium DKTK, Heidelberg, Germany

来源：

JNCI CANCER SPECTRUM | 2021年 / 5卷 / 05期

基金：

美国国家卫生研究院; 瑞典研究理事会;

关键词：

LIFE-STYLE FACTORS; CIGARETTE-SMOKING; COLON-CANCER; NURSES HEALTH; RISK-FACTORS; PREDIAGNOSTIC SMOKING; ALCOHOL-CONSUMPTION; ACTIVE SMOKING; SURVIVAL; MORTALITY;

D O I：

10.1093/jncics/pkab077

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies, but current evidence on smoking in association with survival after CRC diagnosis is limited. Methods: We pooled data from 12 345 patients with stage I-IV CRC from 11 epidemiologic studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of prediagnostic smoking behavior with overall, CRC-specific, and non-CRC-specific survival. Results: Among 12 345 patients with CRC, 4379 (35.5%) died (2515 from CRC) over a median follow-up time of 7.5years. Smoking was strongly associated with worse survival in stage I-III patients, whereas no association was observed among stage IV patients. Among stage I-III patients, clear dose-response relationships with all survival outcomes were seen for current smokers. For example, current smokers with 40 or more pack-years had statistically significantly worse overall, CRC-specific, and non-CRC-specific survival compared with never smokers (hazard ratio [HR] =1.94, 95% confidence interval [CI] =1.68 to 2.25; HR = 1.41, 95% CI = 1.12 to 1.78; and HR = 2.67, 95% CI = 2.19 to 3.26, respectively). Similar associations with all survival outcomes were observed for former smokers who had quit for less than 10 years, but only a weak association with non-CRC-specific survival was seen among former smokers who had quit for more than 10 years. Conclusions: This large consortium of CRC patient studies provides compelling evidence that smoking is strongly associated with worse survival of stage I-III CRC patients in a clear dose-response manner. The detrimental effect of smoking was primarily related to noncolorectal cancer events, but current heavy smoking also showed an association with CRC-specific survival.

引用

页数：9

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