Huang Yu-Min, Wei Po-Li, Ho Chung-Han, Yeh Chih-Ching
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan.
J Clin Med. 2022 Feb 9;11(4):913. doi: 10.3390/jcm11040913.
We investigate whether cigarette smoking is associated with survival in patients with colorectal cancer (CRC) through a nationwide population-based cohort study in Taiwan. The Taiwan Cancer Registry and National Health Insurance Research Database were used to identify data from patients with CRC from 2011 to 2017. Tobacco use was evaluated based on the smoking status, intensity, and duration before cancer diagnosis. A total of 18,816 patients was included. A Kaplan-Meier survival analysis indicated smoking to be significantly associated with the CRC mortality risk (log-rank = 0.0001). A multivariable Cox model indicated that smoking patients had a 1.11-fold higher mortality risk (HR = 1.11, 95% CI = 1.05-1.19) than nonsmoking patients did. This increased risk was also present in patients with CRC who smoked 11-20 cigarettes per day (HR = 1.16; 95% CI = 1.07-1.26) or smoked for >30 years (HR = 1.14; 95% CI = 1.04-1.25). Stratified analyses of sex and cancer subsites indicated that the effects of smoking were higher in male patients and in those with colon cancer. Our results indicate that cigarette smoking is significantly associated with poor survival in patients with CRC. An integrated smoking cessation campaign is warranted to prevent CRC mortality.
我们通过台湾一项基于全国人口的队列研究，调查吸烟是否与结直肠癌（CRC）患者的生存率相关。利用台湾癌症登记处和国民健康保险研究数据库，识别2011年至2017年CRC患者的数据。根据癌症诊断前的吸烟状况、强度和持续时间评估烟草使用情况。共纳入18,816例患者。Kaplan-Meier生存分析表明，吸烟与CRC死亡风险显著相关（对数秩检验P = 0.0001）。多变量Cox模型表明，吸烟患者的死亡风险比不吸烟患者高1.11倍（风险比[HR]=1.11，95%置信区间[CI]=1.05-1.19）。这种风险增加在每天吸11-20支烟（HR = 1.16；95% CI = 1.07-1.26）或吸烟超过30年（HR = 1.14；95% CI = 1.04-1.25）的CRC患者中也存在。按性别和癌症亚部位进行的分层分析表明，吸烟对男性患者和结肠癌患者的影响更大。我们的结果表明，吸烟与CRC患者的不良生存率显著相关。有必要开展综合戒烟运动以预防CRC死亡。
