Smoking and survival of breast cancer patients: A meta-analysis of cohort studies

Duan, Wenhou; Li, Suyun; Meng, Xia; Sun, Yanxin; Jia, Chongqi

doi:10.1016/j.breast.2017.03.012

Cited by 41 publications

(33 citation statements)

References 43 publications

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“…The studies included in this systematic review and meta-analysis provide strong and consistent evidence of poorer prognosis after a PCa diagnosis for smokers than for nonsmokers. This finding is in line with recent reviews investigating the impact of tobacco smoking on survival after a diagnosis of colorectal, [39] breast, [40] and urothelial cancer [41], which have also found those who smoke at diagnosis have a poorer prognosis. Given the median prevalence of current tobacco smoking in the studies included in this review was 16%, it is likely that tobacco smoking is responsible for a substantial burden of premature mortality among people diagnosed with PCa.…”

Section: Discussionsupporting

confidence: 90%

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

Darcey

Boyle

2018

Cancer Treatment Reviews

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The results of this systematic review and meta-analysis indicate that tobacco smoking at prostate cancer diagnosis is associated with a significantly increased risk of overall mortality, prostate-cancer specific mortality and recurrence. We recommend future studies collect more detailed information about tobacco smoking to further understanding of the association between tobacco smoking and PCa prognosis. In addition, further research should concentrate on the impact of smoking cessation post-diagnosis and post-treatment on prognosis, and the feasibility and effectiveness of smoking cessation programs.

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Section: Discussionsupporting

confidence: 90%

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

Darcey

Boyle

2018

Cancer Treatment Reviews

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“…We conducted multiple sensitivity analyses: excluding women with smoking‐related comorbidities (cardiovascular disease, diabetes and lung cancer; assessed at the same time as the exposure); excluding women diagnosed with breast or lung cancer, since these cancers are common in women and smoking is related to mortality in these patients populations; including participants missing tumor stage (using a missing indicator); and excluding mucinous ovarian cancer cases, for whom smoking is an established risk factor . For prediagnosis exposures, we secondarily evaluated exposures reported at least 4 years prior to ovarian cancer diagnosis to ensure that subclinical disease and related symptomology did not affect smoking status.…”

Section: Methodsmentioning

confidence: 99%

Prediagnosis and postdiagnosis smoking and survival following diagnosis with ovarian cancer

Wang

Townsend

Simmons

et al. 2019

Intl Journal of Cancer

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Little is known about the influence of prediagnosis and postdiagnosis smoking and smoking cessation on ovarian cancer survival. We investigated this relationship in two prospective cohort studies, the Nurses' Health Study (NHS) and NHSII. Analyses included 1,279 women with confirmed invasive, Stage I-III epithelial ovarian cancer. We used Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for ovarian cancer-specific mortality by smoking status, adjusting for age and year of diagnosis, tumor stage, histologic subtype, body mass index and nonsteroidal anti-inflammatory use (postdiagnosis models only). When examining prediagnosis smoking status (assessed a median of 12 months before diagnosis), risk of death was significantly increased for former smokers (HR = 1.19, 95% CI: 1.02-1.39), and suggestively for current smokers (HR = 1.21, 95% CI: 0.96-1.51) vs. never smokers. Longer smoking duration (≥20 years vs. never, HR = 1.23, 95% CI: 1.05-1.45) and higher pack-years (≥20 pack-years vs. never, HR = 1.28, 95% CI: 1.07-1.52) were also associated with worse outcome. With respect to postdiagnosis exposure, women who smoked ≥15 cigarettes per day after diagnosis (assessed a median of 11 months after diagnosis) had increased mortality compared to never smokers (HR = 2.34, 95% CI: 1.63-3.37). Those who continued smoking after diagnosis had 40% higher mortality (HR = 1.40, 95% CI: 1.05-1.87) compared to never smokers. Overall, our results suggest both prediagnosis and postdiagnosis smoking are associated with worse ovarian cancer outcomes.Additional Supporting Information may be found in the online version of this article.

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“…There is a growing body of evidence that suggests these health behaviours are positively associated with improved outcomes in cancer survivors. 4 5 Furthermore, behavioural lifestyle interventions in this population have shown promising effectiveness. 6 7 …”

Section: Introductionmentioning

confidence: 99%

Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals

et al. 2018

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ObjectivesAdoption of healthy lifestyle behaviours has shown promising effectiveness in reducing the high morbidity burden of cancer survivors. Health professionals (HPs) are well suited to provide lifestyle advice but few survivors report receiving guidance from them. This study aimed to explore HPs’ perspective of lifestyle advice (on healthy eating, physical activity, smoking, and alcohol) for cancer survivors.DesignIn-depth semistructured qualitative interviews were conducted by telephone or face to face. Data were analysed using qualitative content analysis.Setting and participantsTwenty-one UK HPs working in secondary care with breast, prostate or colorectal cancer survivors were interviewed.ResultsThe overarching theme was that HPs’ desire to provide lifestyle advice was not necessarily matched by knowledge and action. Three main themes were identified: (1) survivorship-centred barriers to provision, (2) HP-centred barriers to provision, and (3) optimal delivery of lifestyle advice. Results suggested that HPs’ perceptions of survivors’ current status of practising health behaviours, their perceived socioeconomic barriers and ability to practise health behaviours, and HPs’ fear for potential loss of connection with the patient influenced provision of lifestyle advice. Further factors included HPs’ knowledge of healthy lifestyle guidelines, feeling that they were not the ‘right person’ to provide advice, and lack of time and resources. HPs stressed that the optimal delivery of lifestyle advice should (1) be tailored to the individual and delivered throughout the cancer journey, (2) be focused on small and achievable changes framed as part of their treatment regimen and (3) be cost-effective for wide-scale implementation.ConclusionsIncorporation of the identified barriers when developing HP training programmes and lifestyle interventions could increase the probability of successful behavioural change, and thus improve outcomes for cancer survivors.

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Smoking and survival of breast cancer patients: A meta-analysis of cohort studies

Cited by 41 publications

References 43 publications

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis

Prediagnosis and postdiagnosis smoking and survival following diagnosis with ovarian cancer

Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals

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