The benefits of smoking cessation on survival in cancer patients by integrative analysis of multi-omics data

Abstract

Background: Few studies have examined the association between smoking cessation at the time of diagnosis and overall survival among cancer patients. We aimed to assess the benefits of quitting smoking on prognosis.Methods: We obtained cohorts of smoking-related cancer patients from the Cancer Genome Atlas (TCGA) database. Hazard ratios (HR) with 95% confidence intervals (CIs) were calculated to evaluate smoking behavior at cancer diagnosis (reformed smokers vs. current smokers) in association with overall survival using age and multivariate-adjusted Cox regressions analysis. Comprehensive analysis of multi-component data was carried out to determine the genetic and epigenetic landscape differences and their effects on the differential expression genes (DEGs) between reformed smokers and current smokers. The smoking signature was constructed using univariate Cox regression and LASSO-Cox regression model.Results: According to the multivariate-adjusted Cox regressions analysis, quitting smoking was the independent protective factor for overall survival in lung squamous cell carcinoma (LUSC) (HR=0.67, 95%CI=0.48-0.94). A total of 85 key DEGs were found to be affected by different modes of genetic and epigenetic regulation, which might represent key drivers in smokers. At last, we provided the smoking signature which could predict prognosis with high power (HR=1.70, 95% CI=1.19-2.43, AUC= 0.65, 0.67 and 0.70 for 2, 3 and 5-year survival, respectively). The smoking signature was also applicable in other smoking-related cancers, including bladder urothelial carcinoma (HR=1.70, 95% CI=1.01-2.88), cervical carcinoma (HR=5.69, 95% CI=1.37-23.69), head and neck squamous cell carcinoma (HR=1.97, 95% CI=1.41-2.76), lung adenocarcinoma (HR=1.73, 95% CI=1.16-2.57), and pancreatic adenocarcinoma (HR=4.28, 95% CI=1.47-12.47).Conclusions: The present study demonstrated that quitting smoking at diagnosis decreased risk of death in cancer patients. We also provided the smoking signature to evaluate the true effect of smoking, suggesting that smoking cessation could be a part of cancer treatment to improve the survival rate of cancer patients.

Association Between Alcohol Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

“…The association between modifiable lifestyles and the risk of neoplastic and chronic diseases of the genitourinary system has attracted researchers’ attention for a long time ( 34 – 37 ). And lifestyle interventions were found to improve clinical outcomes for cancer or chronic medical conditions, either directly or indirectly ( 34 , 38 – 40 ). The bidirectional relationship between lifestyle factors and disease might be systemic and multifaceted, for which lifestyle interventions might have a positive impact on overall health in addition to optimizing the disease-specific outcomes ( 41 , 42 ).…”

SARS CoV-2 Vaccination Autoimmunity, Antibody Dependent Covid-19 Enhancement and Other Potential Risks: Beneath the Tip of the Iceberg

“…However, increasing risks of COVID-19 hospital death were noticed to be associated with increasing levels of obesity (BMI >40 fully adjusted HR 2.27, 95% CI 1.99-2.58) [73] and an informed personalized risk benefit ratio must be secured. Interestingly, quitting smoking at diagnosis was recently shown to decrease the risk of death in cancer patients [74], and quitting smoking was suggested to alleviate its impact in patients with pneumonia and other COVID-19 associated infections [67,69,75], thus a beneficial advice to quit smoking together with another to lose overweight and to control the blood glucose levels might also help to lower the chances of SARS CoV-2 adenovirus and RNA-based vaccine potential autoimmunity in those individuals.…”

Potential Autoimmunity or Antibody Dependent COVID-19 Enhancement of SARS CoV-2 Vaccination or Convalescent Plasma: A Moral, Legal and Constitutional Right to Know.

“…Interestingly, quitting smoking at diagnosis was recently shown to decrease the risk of death in cancer patients [73], and quitting smoking was suggested to alleviate its impact in patients with pneumonia and other COVID-19 associated infections [66,68,74], thus a beneficial advice to quit smoking together with another to lose overweight and to control the blood glucose levels might also help to lower the chances of SARS CoV-2 adenovirus and RNA-based vaccine potential autoimmunity in those individuals.…”