Cited by 265Smoking Behavior and CessationGlobal Cancer Incidence and ScreeningLung Cancer Diagnosis and Treatment

Smoking at diagnosis and survival in cancer patients

Open access
Warren, Graham W., Kasza, Karin A., Reid, Mary E., Cummings, K. Michael, Marshall, James R.·2013·International Journal of Cancer

Abstract

The effect of smoking on survival in cancer patients is limited by the lack of structured prospective assessments of smoking at diagnosis. To assess the effect of smoking at diagnosis on survival, structured smoking assessments were obtained in a cohort of 5,185 cancer patients within 30 days of a cancer diagnosis between 1982 and 1998. Hazard ratios (HRs) or odds ratios were generated to analyze the effects of smoking at diagnosis on overall mortality (OM) and disease‐specific mortality (DSM) in a patient cohort from 13 disease sites containing at least 100 patients in each disease site. With a minimum of 12 years of follow‐up, current smoking increased OM risk versus recent quit (HR 1.17), former (HR 1.29) and never smokers (HR 1.38) in the overall cohort. Current smoking increased DSM risk versus former (HR 1.23) and never smokers (HR 1.18). In disease sites with proportionately large (>20%) recent quit cohorts (lung and head/neck), current smoking increased OM and DSM risks as compared with recent quit. Current smoking increased mortality risks in lung, head/neck, prostate and leukemia in men and breast, ovary, uterus and melanoma in women. Current smoking was not associated with any survival benefit in any disease site. Data using prospective structured smoking assessments demonstrate that current smoking increased long‐term OM and DSM. Standardized smoking assessment at diagnosis is an important variable for evaluating outcomes in cancer patients.

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  • Quitting smoking after a cancer diagnosis reduces harms and improves prognosis and survival odds.

    “By contrast, quitting smoking after a cancer diagnosis dramatically reduces these harms and improves prognosis and odds of survival.6,12,13”

    From Efficacy of smartphone applications to help cancer patients quit smoking: Protocol of the Quit2Heal randomized controlled trial (2023) · cites this paper as [6]

    The Abstract reports higher overall mortality among patients smoking at diagnosis than among recent quitters, and the Epidemiology section suggests cessation may benefit cancer patients. But smoking was assessed only around diagnosis, with no follow-up smoking assessment; the paper does not establish that quitting after diagnosis dramatically reduces harms or causes better survival. (LLM, conf=0.90)

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  • Up to 80% of cancer patients who smoke continue smoking after their diagnosis.

    “Up to 80% of cancer patients who smoke continue to smoke after their diagnosis.4–6”

    From Efficacy of smartphone applications to help cancer patients quit smoking: Protocol of the Quit2Heal randomized controlled trial (2023) · cites this paper as [6]

    The Patient characteristics section reports smoking status near diagnosis, not whether patients continued smoking afterward. The Epidemiology section explicitly says the study had no follow-up smoking assessment. A search for the 80% continuation figure found no passage establishing it; page numbers were unavailable in our copy. (LLM, conf=0.78)

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Research works printed but not linked: 6

  1. [2]2. V C 2012 UICC 10970215, 2013, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ijc.27617, Wiley Online Library on [14/08/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Smoking and survival in cancer patients Int. J. Cancer: 132, 401-410 (2013)
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  3. [18]18. Ahrendt SA, Decker PA, Alawi EA, et al. Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung. Cancer 2001;92:1525-30.
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Authors
Warren, G. W., Kasza, K. A., Reid, M. E., Cummings, K. M., & Marshall, J. R.
Affiliations
  • Roswell Park Comprehensive Cancer Center (US)
  • Medical University of South Carolina (US)
Corresponding author
Warren, Graham W.
Venue
International Journal of Cancer
Publisher
Wiley
Published
2012-05-17
Volume
132
Issue
2
Pages
401-410
ISSN
  • 0020-7136 (ISSN-L)
  • 1097-0215
OpenAlex
W1981663682
Cited by
265
References
43
Citations by year
2026: 8 · 2025: 18 · 2024: 15 · 2023: 27 · 2022: 25 · 2021: 21 · 2020: 20 · 2019: 19 · 2018: 16 · 2017: 19 · 2016: 17 · 2015: 11 · 2014: 21 · 2013: 25 · 2012: 3
FWCI
12.87
Type
journal article
Language
en
Open access
Locations
  • International Journal of Cancer (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords
cancer survival, mortality, current smoking, smoking cessation, former smokers, never smokers, disease-specific mortality, all-cause mortality, tumor location, lung cancer, head and neck cancer, prostate cancer, leukemia, breast cancer, ovarian cancer, uterine cancer, melanoma
MeSH terms
Female, Humans, Male, Middle Aged, Neoplasms, Prognosis, Prospective Studies, Surveys and Questionnaires, Risk Factors, Smoking, Proportional Hazards Models, Survival Analysis, Smoking Cessation, Kaplan-Meier Estimate

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