Journal Article

DKFZ-2021-02437

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Smoking Behavior and Prognosis After Colorectal Cancer Diagnosis: A Pooled Analysis of 11 Studies.

Alwers, E. (First author)DKFZ* ; Carr, P.DKFZ* ; Banbury, B. ; Walter, V.DKFZ* ; Chang-Claude, J.DKFZ* ; Jansen, L.DKFZ* ; Drew, D. A. ; Giovannucci, E. ; Nan, H. ; Berndt, S. I. ; Huang, W.-Y. ; Prizment, A. ; Hayes, R. B. ; Sakoda, L. C. ; White, E. ; Labadie, J. ; Slattery, M. ; Schoen, R. E. ; Diergaarde, B. ; van Guelpen, B. ; Campbell, P. T. ; Peters, U. ; Chan, A. T. ; Newcomb, P. A. ; Hoffmeister, M.DKFZ* ; Brenner, H. (Last author)DKFZ*

2021
Oxford University Press Oxford

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Please use a persistent id in citations: doi:10.1093/jncics/pkab077

Abstract: 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.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.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.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.

Note: #EA:C070#LA:C070#

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Contributing Institute(s):

1. C070 Klinische Epidemiologie und Alternf. (C070)
2. Präventive Onkologie (C120)
3. DKTK HD zentral (HD01)
4. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2021

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Database coverage:
; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; PubMed Central ; Web of Science Core Collection

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