Smoking Status and Survival Among a National Cohort of Lung and Colorectal Cancer Patients

Japuntich, Sandra J.; Kumar, Pallavi; Pendergast, Jane; Caballero, Grelda Yazmin Juarez; Malin, Jennifer L.; Wallace, Robert B.; Chrischilles, Elizabeth A.; Keating, Nancy L.; Park, Elyse R.

doi:10.1093/ntr/nty012

Cited by 25 publications

(17 citation statements)

References 52 publications

(76 reference statements)

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“…Overall, adults with a cancer diagnosis had lower rates of smoking and higher rates of quitting than adults without cancer, regardless of SUD status. Our estimate of smoking prevalence in patients with cancer (and without SUDs) is largely consistent with the most recent population-based estimate of adults with cancer using the National Health Interview Survey from 2017 (i.e., 13% prevalence), as well as other estimates of smoking prevalence from community-based samples (e.g., 14–15%) [ 10 , 19 , 20 , 21 ]. We also found a lower prevalence of SUDs in adults with versus without cancer.…”

Section: Discussionsupporting

confidence: 84%

Association of Cigarette Use and Substance Use Disorders among US Adults with and without a Recent Diagnosis of Cancer

et al. 2020

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Background: Few studies have examined substance use disorders (SUDs) in cancer patients and it is unclear whether SUDs differentially impact cigarette smoking in patients with vs. without cancer. This study used epidemiological data to estimate current cigarette smoking prevalence and quit ratios among US adults with and without SUDs by cancer status. Methods: Data were drawn from the 2015–2018 National Survey on Drug Use and Health (n = 170,111). Weighted current smoking prevalence and quit ratios were estimated across survey years by SUDs (with vs. without) and by cancer status (with vs. without). Results: Among those with cancer, current smoking prevalence was higher for those with vs. without SUDs (47% vs. 13%, p < 0.001) and quit ratios lower for those with vs. without SUDs (45% vs. 71%, p = 0.002). A similar pattern was observed in adults without cancer, with higher smoking prevalence (56% vs. 21%, p < 0.001) and lower quit ratios (23% vs. 51%, p < 0.001) observed for those with vs. without SUDs, respectively. In adjusted logistic regressions, the SUD × cancer status interaction was not significant for smoking prevalence or quit ratios (AOR = 1.2; 95% CI: 0.7, 2.1, p = 0.56; AOR = 1.0; 95% CI: 0.5, 2.0, p = 0.91, respectively), though smoking prevalence was lower and quit ratios higher for adults with vs. without cancer (ps < 0.05). Conclusions: Among US adults with and without cancer, individuals with SUDs evidenced higher cigarette smoking and lower quit ratios than those without SUDs. Addressing SUDs and their impact on smoking cessation is critical in cancer patients with implications for improving health and treatment outcomes.

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Section: Discussionsupporting

confidence: 84%

Association of Cigarette Use and Substance Use Disorders among US Adults with and without a Recent Diagnosis of Cancer

et al. 2020

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“…However, the present study has several limitations. A previous study found that never-smokers had a lower mortality risk than current smokers (HR 0.79, 95% CI, 0.64 to 0.99) among CRC patients [ 34 ], but smoking status was not included in our analysis. Some treatments, such as surgery, chemotherapy, and radiotherapy, were also not included.…”

Section: Discussionmentioning

confidence: 99%

Nomogram based on homogeneous and heterogeneous associated factors for predicting distant metastases in patients with colorectal cancer

et al. 2021

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Background The identification of the homogeneous and heterogeneous risk factors for different types of metastases in colorectal cancer (CRC) may shed light on the aetiology and help individualize prophylactic treatment. The present study characterized the incidence differences and identified the homogeneous and heterogeneous risk factors associated with distant metastases in CRC. Methods CRC patients registered in the SEER database between 2010 and 2016 were included in this study. Logistic regression was used to analyse homogeneous and heterogeneous risk factors for the occurrence of different types of metastases. Nomograms were constructed to predict the risk for developing metastases, and the performance was quantitatively assessed using the receiver operating characteristics (ROC) curve and calibration curve. Results A total of 204,595 eligible CRC patients were included in our study, and 17.07% of them had distant metastases. The overall incidences of liver metastases, lung metastases, bone metastases, and brain metastases were 15.34%, 5.22%, 1.26%, and 0.29%, respectively. The incidence of distant metastases differed by age, gender, and the original CRC sites. Poorly differentiated grade, more lymphatic metastasis, higher carcinoembryonic antigen (CEA), and different metastatic organs were all positively associated with four patterns of metastases. In contrast, age, sex, race, insurance status, position, and T stage were heterogeneously associated with metastases. The calibration and ROC curves exhibited good performance for predicting distant metastases. Conclusions The incidence of distant metastases in CRC exhibited distinct differences, and the patients had homogeneous and heterogeneous associated risk factors. Although limited risk factors were included in the present study, the established nomogram showed good prediction performance.

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“…In our study, the smoker group included significantly younger patients (median age, 73 vs. 68 years, p = 0.009), which may have affected this result. The association between smoking status and survival in patients with colorectal cancer has yet to be established, with most [22][23][24][25] but not all studies [26][27][28], linking cigarette smoking to worse survival rates.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke

et al. 2020

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Serum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the disease status. Thus, we aimed to evaluate the impact of smoking on the prognostic value of serum CEA levels. This retrospective cohort study included 273 patients who underwent curative resection for stage I-III colorectal adenocarcinoma at a single institution, between January 2010 and December 2017. Patients were grouped as follows: group A, normal preoperative and postoperative CEA levels (n = 152); group B, elevated preoperative CEA levels that returned to reference values after surgery (n = 69); and group C, elevated postoperative serum CEA levels (n = 52). Patients were also grouped according to their smoking history: group S (current smokers, n = 79) and group NS (never and former smokers, n = 194). Group A showed a higher 3-year disease-free survival (DFS) rate (84.9%) than groups B (75.4%) and C (62.0%) (p < 0.001). Postoperative serum CEA levels were significantly higher in the S group than in the NS group (2.6 vs. 3.1 ng/mL, p = 0.009), whereas preoperative levels were similar (3.8 vs. 4.1, p = 0.182). Further, smokers showed higher 3 year-DFS rates than nonsmokers in group C (83.3% vs. 43.9%, p = 0.029). This suggests that while elevated postoperative CEA levels are associated with lower DFS rates in never and former smokers, they are not associated with lower DFS rates in current smokers. We conclude that persistent smoking alters the prognostic value of postoperative serum CEA levels in colorectal cancer patients and that, consequently, alternative surveillance strategies need to be developed for colon cancer patients with smoking habits.

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Smoking Status and Survival Among a National Cohort of Lung and Colorectal Cancer Patients

Cited by 25 publications

References 52 publications

Association of Cigarette Use and Substance Use Disorders among US Adults with and without a Recent Diagnosis of Cancer

Association of Cigarette Use and Substance Use Disorders among US Adults with and without a Recent Diagnosis of Cancer

Nomogram based on homogeneous and heterogeneous associated factors for predicting distant metastases in patients with colorectal cancer

Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke

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