Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
The Health Psychology Clinic, Moruya, New South Wales, Australia.
Cancer. 2019 Dec 1;125(23):4260-4268. doi: 10.1002/cncr.32431. Epub 2019 Aug 7.
Fear of cancer recurrence (FCR) adversely affects quality of life. Cigarette smoking increases the risk of recurrence and may exacerbate FCR among survivors who smoke. FCR also may motivate quitting, but research on whether quitting reduces long-term survivors' FCR is lacking. Among long-term survivors of various cancers, the authors investigated relationships between quitting (vs smoking) and FCR, controlling for sociodemographic, cancer-related, and health-related variables.
Data from the American Cancer Society's Longitudinal Study of Cancer Survivors-I were used in generalized estimating equations to compare FCR at 3 waves (T1-T3) after diagnosis between 2 groups; survivors who reported current smoking (n = 196) approximately 9 years after diagnosis (at T3) or who, based on T3 recall of quitting age, had quit smoking after diagnosis (n = 97). T3 cross-sectional analyses among current smokers examined associations of FCR with smoking level and intentions of quitting.
A significant smoking status × time interaction (P = .003) indicated that only quitters experienced decreases in FCR from T1 to T3 (P = .007). At T3, FCR was significantly lower among quitters than among current smokers (P = .05), and current smokers reported that FCR caused more functioning impairments (eg, disruption of relationships, everyday activities, mood) than quitters (P = .001). Cross-sectional analyses (T3) among smokers found that heavier smoking predicted less attempts to cope with FCR (P = .04) and that reassurance behaviors (eg, self-examination for cancer) predicted stronger quitting intentions (P = .02).
Quitting smoking lowers FCR, and FCR may disrupt functioning among continuing smokers. Interventions for FCR should be multimodal and should treat both psychological distress and health-related behaviors such as smoking.
对癌症复发的恐惧（FCR）会对生活质量产生不利影响。吸烟会增加复发的风险，并可能使吸烟幸存者的 FCR 恶化。FCR 也可能促使戒烟，但缺乏关于戒烟是否会降低长期幸存者 FCR 的研究。在各种癌症的长期幸存者中，作者研究了戒烟（与吸烟相比）与 FCR 之间的关系，控制了社会人口统计学、癌症相关和健康相关的变量。
使用广义估计方程，使用美国癌症协会癌症幸存者纵向研究-I 的数据，比较诊断后 3 波（T1-T3）时两组之间的 FCR；报告当前吸烟的幸存者（n=196）约在诊断后 9 年（在 T3 时）或根据 T3 戒烟年龄回忆，在诊断后戒烟的幸存者（n=97）。当前吸烟者的 T3 横断面分析研究了 FCR 与吸烟水平和戒烟意愿的关系。
吸烟状况×时间的交互作用具有统计学意义（P=0.003），这表明只有戒烟者从 T1 到 T3 时 FCR 下降（P=0.007）。在 T3 时，戒烟者的 FCR 明显低于当前吸烟者（P=0.05），当前吸烟者报告 FCR 导致更多的功能障碍（例如，人际关系、日常活动、情绪中断）比戒烟者（P=0.001）更多。吸烟者的横断面分析（T3）发现，吸烟量越大，试图应对 FCR 的次数越少（P=0.04），而安慰行为（例如，自我检查癌症）预测戒烟意愿越强（P=0.02）。
戒烟可降低 FCR，FCR 可能会干扰继续吸烟者的功能。FCR 的干预措施应该是多模式的，应同时治疗心理困扰和吸烟等与健康相关的行为。
