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@ARTICLE{Alwers:177325,
      author       = {E. Alwers$^*$ and P. Carr$^*$ and B. Banbury and V.
                      Walter$^*$ and J. Chang-Claude$^*$ and L. Jansen$^*$ and D.
                      A. Drew and E. Giovannucci and H. Nan and S. I. Berndt and
                      W.-Y. Huang and A. Prizment and R. B. Hayes and L. C. Sakoda
                      and E. White and J. Labadie and M. Slattery and R. E. Schoen
                      and B. Diergaarde and B. van Guelpen and P. T. Campbell and
                      U. Peters and A. T. Chan and P. A. Newcomb and M.
                      Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{S}moking {B}ehavior and {P}rognosis {A}fter {C}olorectal
                      {C}ancer {D}iagnosis: {A} {P}ooled {A}nalysis of 11
                      {S}tudies.},
      journal      = {JNCI cancer spectrum},
      volume       = {5},
      number       = {5},
      issn         = {2515-5091},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2021-02437},
      pages        = {pkab077},
      year         = {2021},
      note         = {#EA:C070#LA:C070#},
      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.},
      cin          = {C070 / C120 / HD01 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34738070},
      pmc          = {pmc:PMC8561259},
      doi          = {10.1093/jncics/pkab077},
      url          = {https://inrepo02.dkfz.de/record/177325},
}