Koshiaris C, Aveyard P, Oke J, Ryan R, Szatkowski L, Stevens R, Farley A
Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK.
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Br J Cancer. 2017 Oct 10;117(8):1224-1232. doi: 10.1038/bjc.2017.179. Epub 2017 Sep 12.
The aim was to examine the association between smoking cessation and prognosis in smoking-related cancer as it is unclear that cessation reduces mortality.
In this retrospective cohort study from 1999 to 2013, we assessed the association between cessation during the first year after diagnosis and all-cause and cancer-specific mortality.
Of 2882 lung, 757 upper aero-digestive tract (UAT) and 1733 bladder cancer patients 27%, 29% and 21% of lung, UAT and bladder cancer patients quit smoking. In lung cancer patients that quit, all-cause mortality was significantly lower (HR: 0.82 (0.74-0.92), while cancer-specific mortality (HR: 0.89 (0.76-1.04) and death due to index cancer (HR: 0.90 (0.77-1.05) were non-significantly lower. In UAT cancer, all-cause mortality (HR: 0.81 (0.58-1.14), cancer-specific mortality (HR: 0.84 (0.48-1.45), and death due to index cancer (HR: 0.75 (0.42-1.34) were non-significantly lower. There was no evidence of an association between quitting and mortality in bladder cancer. The HRs were 1.02 (0.81-1.30) for all-cause, 1.23 (0.81-1.86) for cancer specific, and 1.25 (0.71-2.20) for death due to index cancer. These showed a non-significantly lower risk in sensitivity analyses.
People with lung and possibly UAT cancer who quit smoking have a lower risk of mortality than people who continue smoking.
目的是研究戒烟与吸烟相关癌症预后之间的关联，因为尚不清楚戒烟是否能降低死亡率。
在这项1999年至2013年的回顾性队列研究中，我们评估了诊断后第一年戒烟与全因死亡率和癌症特异性死亡率之间的关联。
在2882例肺癌、757例上消化道（UAT）癌和1733例膀胱癌患者中，肺癌、UAT癌和膀胱癌患者分别有27%、29%和21%戒烟。在戒烟的肺癌患者中，全因死亡率显著降低（风险比：0.82（0.74 - 0.92）），而癌症特异性死亡率（风险比：0.89（0.76 - 1.04））和因原发性癌症导致的死亡（风险比：0.90（0.77 - 1.05））降低不显著。在UAT癌中，全因死亡率（风险比：0.81（0.58 - 1.14））、癌症特异性死亡率（风险比：0.84（0.48 - 1.45））和因原发性癌症导致的死亡（风险比：0.75（0.42 - 1.34））降低不显著。没有证据表明膀胱癌患者戒烟与死亡率之间存在关联。全因死亡率的风险比为1.02（0.81 - 1.30），癌症特异性死亡率的风险比为1.23（0.81 - 1.86），因原发性癌症导致的死亡的风险比为1.25（0.71 - 2.20）。这些在敏感性分析中显示风险降低不显著。
肺癌患者以及可能的UAT癌患者戒烟后的死亡风险低于继续吸烟者。
