Impact of Prediagnosis Smoking, Alcohol, Obesity, and Insulin Resistance on Survival in Male Cancer Patients: National Health Insurance Corporation Study
Open accessAbstract
Purpose: Although many studies have demonstrated that smoking, alcohol, obesity, and insulin resistance are risk factors for cancer, the role of those factors on cancer survival has been less studied. Patients and Methods: The study participants were 14,578 men with a first cancer derived from a cohort of 901,979 male government employees and teachers who participated in a national health examination program in 1996. We obtained mortality data for those years from the Korean Statistical Office. We used a standard Poisson regression model to estimate the hazard ratio (HR) for survival in relation to smoking, alcohol, obesity, and insulin resistance before diagnosis. Results: Poor survival of all cancer combined (HR, 1.24; 95% CI, 1.16 to 1.33), cancer of the lung (HR, 1.45; 95% CI, 1.15 to 1.82), and cancer of the liver (HR, 1.36; 95% CI, 1.21 to 1.53) were significantly associated with smoking. Compared with the nondrinker, heavy drinkers had worse outcomes for head and neck (HR, 1.85; 95% CI, 1.23 to 2.79) and liver (HR, 1.25; 95% CI, 1.11 to 1.41) cancer, with dose-dependent relationships. Patients with a fasting serum glucose level above 126 mg/dL had a higher mortality rate for stomach (HR, 1.52; 95% CI, 1.25 to 1.84) and lung (HR, 1.48; 95% CI, 1.18 to 1.87) cancer. Higher body mass index was significantly associated with longer survival in head and neck (HR, 0.54; 95% CI, 0.39 to 0.74) and esophagus (HR, 0.44; 95% CI, 0.28 to 0.68) cancer. Conclusion: Prediagnosis risk factors for cancer development (smoking, alcohol consumption, obesity, and insulin resistance) had a statistically significant effect on survival among male cancer patients.
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Alcohol may prevent cancer by increasing insulin sensitivity, thereby decreasing the risk of kidney cancer.
“First, by increasing insulin sensitivity, alcohol may decrease the risk of kidney cancer 159, 160; in contrast, insulin resistance has been observed to be a risk factor for cancer independent of other risk factors such as obesity 161, 162.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [159]
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- Authors
- Park, S. M., Lim, M. K., Shin, S. A., & Yun, Y. H.
- Affiliations
- National Cancer Center (KR)
- Venue
- Journal of Clinical Oncology
- Published
- 2006-11-01
- Volume
- 24
- Issue
- 31
- Pages
- 5017-5024
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2151964573
- Cited by
- 263
- References
- 47
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 10 · 2021: 10 · 2020: 16 · 2019: 11 · 2018: 22 · 2017: 20 · 2016: 19 · 2015: 18 · 2014: 25 · 2013: 22 · 2012: 18
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- cancer survival, smoking, alcohol consumption, obesity, insulin resistance, fasting serum glucose, body mass index, lung cancer, liver cancer, head and neck cancer, esophageal cancer, gastric cancer, male cancer patients
- MeSH terms
- Adult, Aged, Alcohol Drinking, Blood Glucose, Follow-Up Studies, Head and Neck Neoplasms, Humans, Insulin Resistance, Korea, Liver Neoplasms, Male, Middle Aged, Neoplasms, Obesity, Prospective Studies, Risk Factors, Smoking, Stomach Neoplasms, Comorbidity, Body Mass Index, Survival Rate, Poisson Distribution
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