Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-Ku, Tokyo, Japan.
Int J Cancer. 2017 Apr 15;140(8):1789-1795. doi: 10.1002/ijc.30601. Epub 2017 Jan 30.
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.
很少有研究探讨癌症患者诊断时的吸烟行为（尤其是戒烟者）与死亡率之间的关系。我们的目的是研究戒烟对癌症患者全因死亡率的益处。通过日本一家医院癌症登记处确定的 1985 年至 2009 年间诊断出的 30658 名符合条件的癌症患者，对其进行了长达 10 年的随访。我们使用 Cox 比例风险模型和协变量调整后的生存曲线，评估了癌症诊断时的吸烟行为（尤其是最近戒烟者与当前吸烟者）与全因死亡率之间的关系。与当前吸烟者相比，最近戒烟者的死亡风险降低了 11%。根据调整后的生存曲线，最近戒烟者的中位生存时间为 8.25 年，而当前吸烟者为 7.18 年，这意味着中位幸存者的绝对差异为 1.07 年。同样，从不吸烟者和曾经吸烟者的死亡风险分别降低了 18%和 16%，中位生存时间分别延长了 1.90 年和 1.77 年。除了从不吸烟者和曾经吸烟者外，最近戒烟者在癌症患者诊断后 10 年的日历期间，其生存率始终高于当前吸烟者。由于最近戒烟者在吸烟时间方面可能与癌症诊断后不久就戒烟的患者相似，后者可能能够降低死亡风险，这表明戒烟可能是癌症治疗的一部分。
