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Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies

BACKGROUND: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies, but current evidence on smoking in association with survival after CRC diagnosis is limited. METHODS: We pooled data from 12 345 patients with stage I-IV CRC from 11 epidemiologic studie...

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Autores principales: Alwers, Elizabeth, Carr, Prudence R, Banbury, Barbara, Walter, Viola, Chang-Claude, Jenny, Jansen, Lina, Drew, David A, Giovannucci, Edward, Nan, Hongmei, Berndt, Sonja I, Huang, Wen-Yi, Prizment, Anna, Hayes, Richard B, Sakoda, Lori C, White, Emily, Labadie, Julia, Slattery, Martha, Schoen, Robert E, Diergaarde, Brenda, van Guelpen, Bethany, Campbell, Peter T, Peters, Ulrike, Chan, Andrew T, Newcomb, Polly A, Hoffmeister, Michael, Brenner, Hermann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561259/
https://www.ncbi.nlm.nih.gov/pubmed/34738070
http://dx.doi.org/10.1093/jncics/pkab077
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author Alwers, Elizabeth
Carr, Prudence R
Banbury, Barbara
Walter, Viola
Chang-Claude, Jenny
Jansen, Lina
Drew, David A
Giovannucci, Edward
Nan, Hongmei
Berndt, Sonja I
Huang, Wen-Yi
Prizment, Anna
Hayes, Richard B
Sakoda, Lori C
White, Emily
Labadie, Julia
Slattery, Martha
Schoen, Robert E
Diergaarde, Brenda
van Guelpen, Bethany
Campbell, Peter T
Peters, Ulrike
Chan, Andrew T
Newcomb, Polly A
Hoffmeister, Michael
Brenner, Hermann
author_facet Alwers, Elizabeth
Carr, Prudence R
Banbury, Barbara
Walter, Viola
Chang-Claude, Jenny
Jansen, Lina
Drew, David A
Giovannucci, Edward
Nan, Hongmei
Berndt, Sonja I
Huang, Wen-Yi
Prizment, Anna
Hayes, Richard B
Sakoda, Lori C
White, Emily
Labadie, Julia
Slattery, Martha
Schoen, Robert E
Diergaarde, Brenda
van Guelpen, Bethany
Campbell, Peter T
Peters, Ulrike
Chan, Andrew T
Newcomb, Polly A
Hoffmeister, Michael
Brenner, Hermann
author_sort Alwers, Elizabeth
collection PubMed
description BACKGROUND: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies, but current evidence on smoking in association with survival after CRC diagnosis is limited. METHODS: We pooled data from 12 345 patients with stage I-IV CRC from 11 epidemiologic studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of prediagnostic smoking behavior with overall, CRC-specific, and non-CRC-specific survival. RESULTS: Among 12 345 patients with CRC, 4379 (35.5%) died (2515 from CRC) over a median follow-up time of 7.5 years. Smoking was strongly associated with worse survival in stage I-III patients, whereas no association was observed among stage IV patients. Among stage I-III patients, clear dose-response relationships with all survival outcomes were seen for current smokers. For example, current smokers with 40 or more pack-years had statistically significantly worse overall, CRC-specific, and non-CRC-specific survival compared with never smokers (hazard ratio [HR] =1.94, 95% confidence interval [CI] =1.68 to 2.25; HR = 1.41, 95% CI = 1.12 to 1.78; and HR = 2.67, 95% CI = 2.19 to 3.26, respectively). Similar associations with all survival outcomes were observed for former smokers who had quit for less than 10 years, but only a weak association with non-CRC-specific survival was seen among former smokers who had quit for more than 10 years. CONCLUSIONS: This large consortium of CRC patient studies provides compelling evidence that smoking is strongly associated with worse survival of stage I-III CRC patients in a clear dose-response manner. The detrimental effect of smoking was primarily related to noncolorectal cancer events, but current heavy smoking also showed an association with CRC-specific survival.
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spelling pubmed-85612592021-11-03 Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies Alwers, Elizabeth Carr, Prudence R Banbury, Barbara Walter, Viola Chang-Claude, Jenny Jansen, Lina Drew, David A Giovannucci, Edward Nan, Hongmei Berndt, Sonja I Huang, Wen-Yi Prizment, Anna Hayes, Richard B Sakoda, Lori C White, Emily Labadie, Julia Slattery, Martha Schoen, Robert E Diergaarde, Brenda van Guelpen, Bethany Campbell, Peter T Peters, Ulrike Chan, Andrew T Newcomb, Polly A Hoffmeister, Michael Brenner, Hermann JNCI Cancer Spectr Article BACKGROUND: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies, but current evidence on smoking in association with survival after CRC diagnosis is limited. METHODS: We pooled data from 12 345 patients with stage I-IV CRC from 11 epidemiologic studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of prediagnostic smoking behavior with overall, CRC-specific, and non-CRC-specific survival. RESULTS: Among 12 345 patients with CRC, 4379 (35.5%) died (2515 from CRC) over a median follow-up time of 7.5 years. Smoking was strongly associated with worse survival in stage I-III patients, whereas no association was observed among stage IV patients. Among stage I-III patients, clear dose-response relationships with all survival outcomes were seen for current smokers. For example, current smokers with 40 or more pack-years had statistically significantly worse overall, CRC-specific, and non-CRC-specific survival compared with never smokers (hazard ratio [HR] =1.94, 95% confidence interval [CI] =1.68 to 2.25; HR = 1.41, 95% CI = 1.12 to 1.78; and HR = 2.67, 95% CI = 2.19 to 3.26, respectively). Similar associations with all survival outcomes were observed for former smokers who had quit for less than 10 years, but only a weak association with non-CRC-specific survival was seen among former smokers who had quit for more than 10 years. CONCLUSIONS: This large consortium of CRC patient studies provides compelling evidence that smoking is strongly associated with worse survival of stage I-III CRC patients in a clear dose-response manner. The detrimental effect of smoking was primarily related to noncolorectal cancer events, but current heavy smoking also showed an association with CRC-specific survival. Oxford University Press 2021-08-31 /pmc/articles/PMC8561259/ /pubmed/34738070 http://dx.doi.org/10.1093/jncics/pkab077 Text en © The Author(s) 2021. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Article
Alwers, Elizabeth
Carr, Prudence R
Banbury, Barbara
Walter, Viola
Chang-Claude, Jenny
Jansen, Lina
Drew, David A
Giovannucci, Edward
Nan, Hongmei
Berndt, Sonja I
Huang, Wen-Yi
Prizment, Anna
Hayes, Richard B
Sakoda, Lori C
White, Emily
Labadie, Julia
Slattery, Martha
Schoen, Robert E
Diergaarde, Brenda
van Guelpen, Bethany
Campbell, Peter T
Peters, Ulrike
Chan, Andrew T
Newcomb, Polly A
Hoffmeister, Michael
Brenner, Hermann
Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title_full Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title_fullStr Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title_full_unstemmed Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title_short Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies
title_sort smoking behavior and prognosis after colorectal cancer diagnosis: a pooled analysis of 11 studies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561259/
https://www.ncbi.nlm.nih.gov/pubmed/34738070
http://dx.doi.org/10.1093/jncics/pkab077
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