Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
Institute for Health and Society, Hanyang University, Seoul, Korea.
Cancer Res Treat. 2024 Jan;56(1):18-26. doi: 10.4143/crt.2023.341. Epub 2023 Aug 2.
This study investigated association between smoking habit change and cancer-related mortality risk in Korean women.
Study population were women aged ≥ 40 years who underwent two biennial cancer screenings during 2009-2012 and were followed up until 2020. Participants were grouped into sustained nonsmokers, sustained quitters, new quitters, relapsers/smoking initiators, and sustained smokers. Outcomes included all-cause and cancer-related deaths. Cox regression and competing risk analysis was used to assess association between smoking habit change and mortality risk.
Of 2,892,590 women, 54,443 death cases were recorded (median follow-up of 9.0 years). Compared with sustained nonsmokers, mortality risk from all causes and cancer-related causes increased in all other smoking groups. Cancer-related risk increased 1.22-fold among sustained quitters (95% confidence interval [CI], 1.10 to 1.36), 1.56-fold (95% CI, 1.40 to 1.75) in new quitters, 1.40-fold (95% CI, 1.21 to 1.62) in relapsers/smoking initiators, and 1.61-fold (95% CI, 1.46 to 1.78) in sustained smokers compared with sustained nonsmokers. Women who were sustained smokers with higher smoking intensity had a higher mortality risk in terms of hazard ratios compared to nonsmokers (< 5 pack-years 2.12-fold, 5-10 pack-years 2.15-fold, and > 10 pack-years 2.27-fold).
Quitting smoking earlier is critical for preventing death from all causes and cancer among female smokers.
本研究旨在探讨韩国女性吸烟习惯改变与癌症相关死亡风险的关联。
研究对象为年龄≥40 岁的女性，她们在 2009-2012 年期间接受了两次两年一次的癌症筛查，并随访至 2020 年。参与者被分为持续不吸烟者、持续戒烟者、新戒烟者、复吸/开始吸烟者和持续吸烟者。结局包括全因和癌症相关死亡。使用 Cox 回归和竞争风险分析评估吸烟习惯改变与死亡率风险之间的关联。
在 2892590 名女性中，有 54443 例死亡病例（中位随访时间为 9.0 年）。与持续不吸烟者相比，所有其他吸烟组的全因和癌症相关死亡率均升高。持续戒烟者的癌症相关风险增加 1.22 倍（95%置信区间 [CI]，1.10 至 1.36），新戒烟者增加 1.56 倍（95% CI，1.40 至 1.75），复吸/开始吸烟者增加 1.40 倍（95% CI，1.21 至 1.62），持续吸烟者增加 1.61 倍（95% CI，1.46 至 1.78）。与持续不吸烟者相比，持续吸烟且吸烟强度较高的女性的全因死亡率风险更高，其危险比分别为<5 包年 2.12 倍、5-10 包年 2.15 倍和>10 包年 2.27 倍。
对于女性吸烟者而言，尽早戒烟对于预防全因死亡和癌症至关重要。
