Smoking cessation and survival in lung, upper aero-digestive tract and bladder cancer: cohort study

Br J Cancer. 2017 Oct 10;117(8):1224-1232. doi: 10.1038/bjc.2017.179. Epub 2017 Sep 12.

Abstract

Background: The aim was to examine the association between smoking cessation and prognosis in smoking-related cancer as it is unclear that cessation reduces mortality.

Methods: In this retrospective cohort study from 1999 to 2013, we assessed the association between cessation during the first year after diagnosis and all-cause and cancer-specific mortality.

Results: Of 2882 lung, 757 upper aero-digestive tract (UAT) and 1733 bladder cancer patients 27%, 29% and 21% of lung, UAT and bladder cancer patients quit smoking. In lung cancer patients that quit, all-cause mortality was significantly lower (HR: 0.82 (0.74-0.92), while cancer-specific mortality (HR: 0.89 (0.76-1.04) and death due to index cancer (HR: 0.90 (0.77-1.05) were non-significantly lower. In UAT cancer, all-cause mortality (HR: 0.81 (0.58-1.14), cancer-specific mortality (HR: 0.84 (0.48-1.45), and death due to index cancer (HR: 0.75 (0.42-1.34) were non-significantly lower. There was no evidence of an association between quitting and mortality in bladder cancer. The HRs were 1.02 (0.81-1.30) for all-cause, 1.23 (0.81-1.86) for cancer specific, and 1.25 (0.71-2.20) for death due to index cancer. These showed a non-significantly lower risk in sensitivity analyses.

Conclusions: People with lung and possibly UAT cancer who quit smoking have a lower risk of mortality than people who continue smoking.

MeSH terms

  • Aged
  • Carcinoma, Transitional Cell / mortality*
  • Cause of Death
  • Cohort Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality*
  • Male
  • Middle Aged
  • Mortality
  • Mouth Neoplasms / mortality*
  • Pharyngeal Neoplasms / mortality*
  • Proportional Hazards Models
  • Retrospective Studies
  • Smoking / epidemiology*
  • Smoking Cessation / statistics & numerical data*
  • Survival Rate
  • United Kingdom / epidemiology
  • Urinary Bladder Neoplasms / mortality*