Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Ann Oncol. 2013 Oct;24(10):2699-2704. doi: 10.1093/annonc/mdt279. Epub 2013 Jul 25.
Smoking is a well-known risk factor for cancer; however, there is little evidence as to whether the smoking status of cancer survivors has any risk for subsequent primary cancer (SPC) incidence, regardless of the first cancer sites.
In total, 29,795 eligible patients with a first cancer between 1985 and 2004 were examined for SPC until the end of 2006, using a record linkage between hospital-based and population-based cancer registries. The association between smoking at the time of the first cancer diagnosis and three SPC groups (i.e. specific SPC, smoking-related SPCs, and all SPCs) was calculated by Poisson regression.
Ever smokers had 59% and 102% higher risk for all SPCs and smoking-related SPCs, respectively, than never smokers. Cancer survivors who had recently stopped smoking had 18% and 26% less risk, respectively, for these SPCs than those who smoked at the diagnosis. We also found that, compared with those who had never smoked, cancer survivors who had ever smoked had a significantly elevated risk of oral/pharyngeal, esophageal, stomach, lung, and hematological SPCs, regardless of the first cancer sites.
These findings indicate that smoking increases not only the first cancer but also a second or SPC. Moreover, the results from recent quitters versus current smokers suggest that smoking cessation may decrease the risk for SPC, especially for smoking-related SPCs in cancer survivors. Preventive measures are necessary to reduce not only SPC incidence but also tobacco use.
吸烟是癌症的一个已知危险因素；然而，目前几乎没有证据表明癌症幸存者的吸烟状况是否会增加随后发生的原发性癌症（SPC）的风险，无论首次癌症发生的部位如何。
总共对 29795 名符合条件的于 1985 年至 2004 年之间首次患有癌症的患者进行了 SPC 检查，使用基于医院和基于人群的癌症登记处之间的记录链接。通过泊松回归计算首次癌症诊断时吸烟与三个 SPC 组（即特定 SPC、与吸烟相关的 SPC 以及所有 SPC）之间的关联。
与从不吸烟者相比，曾经吸烟者发生所有 SPC 和与吸烟相关的 SPC 的风险分别高出 59%和 102%。与吸烟相比，最近戒烟的癌症幸存者发生这些 SPC 的风险分别降低了 18%和 26%。我们还发现，与从不吸烟者相比，无论首次癌症发生的部位如何，曾经吸烟者发生口腔/咽、食管、胃、肺和血液系统 SPC 的风险显著升高。
这些发现表明，吸烟不仅会增加首次癌症的风险，还会增加第二或 SPC 的风险。此外，与当前吸烟者相比，最近戒烟者的结果表明，戒烟可能会降低 SPC 的风险，特别是对于癌症幸存者的与吸烟相关的 SPC。需要采取预防措施来降低 SPC 的发病率，同时减少烟草使用。
