Health Policy Research Center at the Mongan Institute, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA.
Health Promotion and Resiliency Intervention Research Program, Massachusetts General Hospital, Boston, MB, USA.
Support Care Cancer. 2022 Sep;30(9):7801-7809. doi: 10.1007/s00520-022-07111-5. Epub 2022 May 12.
Continued smoking after a cancer diagnosis limits the effectiveness of treatment, increases the risk of cancer recurrence or secondary malignancies, and is associated with poorer quality of life and survival. A cancer diagnosis may provide a meaningful timepoint for quitting, but the prevalence and characteristics of continued smoking through survivorship are poorly understood.
In the multi-regional Cancer Care Outcomes Research and Surveillance (CanCORS) cohort, we examined smoking rates and factors associated with continued smoking at long-term follow-up among lung and colorectal cancer patients. This paper builds upon previous CanCORS participant data addressing quit rates and associated characteristics at baseline and 5 months post-diagnosis.
At long-term follow-up (median 7.3 years post-diagnosis [IQR = 5.9-8.7]), 16.7% of lung cancer and 11.6% of colorectal cancer survivors continued to smoke combustible cigarettes. Factors independently associated with continued smoking at long-term follow-up included being male, younger, not married or partnered, having Medicare, Medicaid/other public or no insurance, more depression symptoms, smoking more cigarettes per day, and having a history of lung disease (p < .05). Continued smoking did not vary by lung vs. colorectal cancer diagnosis.
Of active smokers at the time of diagnosis, an important minority of lung and colorectal cancer survivors continued to smoke well into survivorship. Understanding characteristics associated with continued smoking after a cancer diagnosis may help inform the development of tobacco treatment programs for cancer patients and survivors.
While addressing smoking cessation at the time of diagnosis is critical to ensure better long-term treatment outcomes and quality of life, it is essential to continue smoking cessation discussions and efforts throughout care and survivorship.
癌症诊断后继续吸烟会降低治疗效果，增加癌症复发或继发恶性肿瘤的风险，并与生活质量和生存状况较差相关。癌症诊断可能为戒烟提供了一个有意义的时间点，但癌症幸存者持续吸烟的流行程度和特征尚未得到充分了解。
在多区域癌症护理结果研究和监测（CanCORS）队列中，我们研究了肺癌和结直肠癌患者在长期随访中持续吸烟的发生率以及与持续吸烟相关的因素。本文以先前的 CanCORS 参与者数据为基础，这些数据涉及在基线和诊断后 5 个月的戒烟率以及相关特征。
在长期随访（诊断后中位时间为 7.3 年[IQR=5.9-8.7]）中，16.7%的肺癌幸存者和 11.6%的结直肠癌幸存者仍继续吸食可燃香烟。长期随访中与持续吸烟独立相关的因素包括男性、年龄较小、未婚或未婚、拥有医疗保险、医疗补助/其他公共或无保险、更多的抑郁症状、每天吸烟更多支以及有肺病病史（p<0.05）。与肺癌或结直肠癌诊断相比，持续吸烟的情况没有差异。
在诊断时为吸烟者的患者中，重要的少数肺癌和结直肠癌幸存者在生存期间仍持续吸烟。了解癌症诊断后持续吸烟的相关特征可能有助于为癌症患者和幸存者制定烟草治疗计划。
虽然在诊断时解决戒烟问题对于确保更好的长期治疗效果和生活质量至关重要，但在整个治疗和生存期间继续进行戒烟讨论和努力也非常重要。
