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  • Alwers, ElizabethDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (author)

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

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2021-08-31
  • Oxford University Press,2021
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-189213
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-189213URI
  • https://doi.org/10.1093/jncics/pkab077DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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 7.5years. Smoking was strongly associated with worse survival in stage I-III patients, whereas no associa-tion 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 over-all, CRC-specific, and non-CRC-specific survival compared with never smokers (hazard ratio [HR] 1/41.94, 95% confidence interval [CI] 1/41.68 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 sur-vival outcomes were observed for former smokers who had quit for less than 10years, but only a weak association with non-CRC-specific survival was seen among former smokers who had quit for more than 10years.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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Added entries (persons, corporate bodies, meetings, titles ...)

  • Carr, Prudence R.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (author)
  • Banbury, BarbaraPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States (author)
  • Walter, ViolaDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (author)
  • Chang-Claude, JennyDivision of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Genetic Tumor Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany (author)
  • Jansen, LinaDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (author)
  • Drew, David A.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States; Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States (author)
  • Giovannucci, EdwardDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, MA, Boston, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, MA, Boston, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA, Boston, United States (author)
  • Nan, HongmeiDepartment of Global Health, Richard M. Fairbanks School of Public Health, IN, Indianapolis, United States (author)
  • Berndt, Sonja I.Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD, Bethesda, United States (author)
  • Huang, Wen-YiDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD, Bethesda, United States (author)
  • Prizment, AnnaDivision of Epidemiology and Community Health, University of Minnesota, MN, Minneapolis, United States (author)
  • Hayes, Richard B.Division of Epidemiology, Department of Population Health, New York University, School of Medicine, NY, New York, United States (author)
  • Sakoda, Lori C.Division of Research, Kaiser Permanente Northern California, CA, Oakland, United States (author)
  • White, EmilyPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States (author)
  • Labadie, JuliaPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States; Department of Epidemiology, University of Washington, School of Public Health, WA, Seattle, United States (author)
  • Slattery, MarthaDepartment of Internal Medicine, University of Utah, UT, Salt Lake City, United States (author)
  • Schoen, Robert E.Departments of Medicine and Epidemiology, University of Pittsburgh, PA, Pittsburgh, United States (author)
  • Diergaarde, BrendaDepartment of Human Genetics, Graduate School of Public Health, University of Pittsburgh, PA, United States; UPMC Hillman Cancer Center, PA, Pittsburgh, United States (author)
  • van Guelpen, BethanyUmeå universitet,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM),Onkologi(Swepub:umu)beyvan99 (author)
  • Campbell, Peter T.Department of Population Science, American Cancer Society, GA, Atlanta, United States (author)
  • Peters, UlrikePublic Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States; Department of Epidemiology, University of Washington, School of Public Health, WA, Seattle, United States (author)
  • Chan, Andrew T.Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States; Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, MA, Boston, United States; Broad Institute of Harvard and MIT, MA, Cambridge, United States (author)
  • Newcomb, Polly A.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States (author)
  • Hoffmeister, MichaelDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany (author)
  • Brenner, HermannDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany (author)
  • Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, GermanyPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, WA, Seattle, United States (creator_code:org_t)

Related titles

  • In:JNCI Cancer Spectrum: Oxford University Press5:52515-5091

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