What do patients with urothelial cancer know about the association of their tumor disease with smoking habits? Results of a German survey study

Abstract

PurposeSmoking represents a primary risk factor for the development of urothelial carcinoma (UC) and a relevant factor impacting UC-specific prognosis. Data on the accordant knowledge of UC-patients in this regard and the significance of physicians in the education of UC-patients is limited.Materials and MethodsEighty-eight UC-patients were enrolled in a 23-items-survey-study aimed to analyse patient knowledge and awareness of their tumor disease with smoking along with physician smoking cessation counselling.ResultsThe median age of the study patients was 69 years; 26.1% (n=23), 46.6% (n=41), and 27.3% (n=24), respectively, were non-smokers, previous, and active smokers. Exactly 50% of active smokers reported a previous communication with a physician about the association of smoking and their tumor disease; however, only 25.0% were aware of smoking as main risk factor for UC development. Merely 33% of the active smokers had been prompted directly by their physicians to quit smoking. About 42% of active smokers had received the information that maintaining smoking could result in a tumor-specific impairment of their prognosis. Closely 29% of active and about 5% of previous smokers (during the time-period of active smoking) had been offered support from physicians for smoking cessation. No association was found between smoking anamnesis (p=0.574) and pack-years (p=0.912), respectively, and tumor stage of UC.ConclusionsThe results of this study suggest that the medical conversation of physicians with UC-patients about the adverse significance of smoking is limited. Implementation of structured educational programs for smoking cessation may be an opportunity to further enhance comprehensive cancer care.

Does Smoking Cessation at Primary Diagnosis Reduce the Recurrence Risk of Nonmuscle-Invasive Bladder Cancer? Results of a Prospective Study

“…Almost 50% of our patients with primary NMIBC were current smokers and 35% of them definitively stopped, with a smoking cessation rate higher than that reported by other authors [17,18].In a retrospective cohort study, Koshiaris et al [17] found a 21% smoking cessation rate among bladder cancer patients, which is lower than the 27 and 29% detected among upper aerodigestive tract cancer and lung cancer patients, respectively. In a recent German survey, only 33% of the active smokers with a primary diagnosis of NMIBC had been prompted to quit smoking [18]. These data implicate the inadequacy of patients' counseling about cigarette smoking and suggest the need for a more active role of the urologists to increase the smoking cessation rate at diagnosis [19][20][21].…”

“…The authors concluded that smoking cessation after diagnosis did not decrease the risk of recurrence compared to continuing smokers, but the power of the statistical analysis is limited by the small number of ex-smokers [16]. Almost 50% of our patients with primary NMIBC were current smokers and 35% of them definitively stopped, with a smoking cessation rate higher than that reported by other authors [17,18].In a retrospective cohort study, Koshiaris et al [17] found a 21% smoking cessation rate among bladder cancer patients, which is lower than the 27 and 29% detected among upper aerodigestive tract cancer and lung cancer patients, respectively. In a recent German survey, only 33% of the active smokers with a primary diagnosis of NMIBC had been prompted to quit smoking [18].…”

The Attitudes and Awareness of Urinary Bladder Cancer Patients about the Relationship Between Their Tumoral Diseases and Tobacco Exposure

“…According to the estimations of World Health Organization in 2013, six million people worldwide died from the diseases caused by smoking including cancer, cardiovascular diseases and pulmonary diseases. [8] Cigarette smoking and occupational exposure are the main risk factors for urothelial carcinoma. In urinary bladder cancer (UBC), cigarette smoking is responsible for about one-third of all diagnosis.…”

“…Only limited studies have shown the communication between patients and their physicians regarding their disease and smoking as well as the awareness and knowledge of UBC patients about the influence of smoking regarding their primary cancer diseases. [8] In this study we aimed to investigate the UBC patients with their history of smoking (tobacco exposure) and to find out the answer for their attitudes and awareness of the exposure -cancer relationship. Moreover, we aimed to show the association between smoking status with the stage, grade and histopathology of the tumoral disease.…”

A Systematic Review and Scoping Analysis of Smoking Cessation after a Urological Cancer Diagnosis

“…Passive Smoking Cessation Rates A total of 21 studies reported passive smoking cessation outcomes (quit rates in the absence of a directed, active intervention) after the diagnosis of a urological cancer (3,669 patients). 19 Of these studies, 17 (81%) included patients with bladder cancer, 7 of which included patients with nonmuscle invasive bladder cancer exclusively. There was wide variation in smoking cessation rates after diagnosis with 14.3% to 79.0% of included adults reporting quitting at some time point after diagnosis (table 3).…”