Duration of smoking abstinence as a predictor for non-small-cell lung cancer survival in women

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2005-02, Vol.47 (2), p.165-172
• Main Authors: Ebbert, J.O., Williams, B.A., Sun, Z., Aubry, M.C., Wampfler, J.A., Garces, Y.I., Meyer, R.L., Yang, P.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Carcinoma; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Cohort Studies; Female; Humans; Lung neoplasms; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Medical sciences; Middle Aged; Non-small-cell lung; Pneumology; Prognosis; Prospective Studies; Risk Factors; Sex; Sex Factors; Small-cell; Smoking Cessation; Survival Analysis; Time Factors; Tobacco, tobacco smoking; Toxicology; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2004.07.045

Background: Previous studies have attempted to investigate the impact of smoking cessation on lung cancer survival but have been limited by small numbers of former smokers and incomplete data. Methods: Over a six-year period, 5229 patients with non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) were enrolled in a prospective cohort of whom 2052 were former smokers. Patient's characteristics were obtained from medical records and a baseline interview. Vital status was determined through multiple sources. Cox proportional hazards models were used to estimate the effect of smoking abstinence on post-diagnosis mortality. Results: For all patients with NSCLC, the median survival among never, former, and current smokers was 1.4 years, 1.3 years, and 1.1 years, respectively ( P < 0.01). Female NSCLC patients had a significantly lower risk of mortality with a longer duration of smoking abstinence (RR per 10 years of smoking abstinence = 0.85; 95% CI: 0.75, 0.97). No effect of smoking abstinence on mortality was observed for women with SCLC or for men with either histologic group. Conclusions: The identification of smoking history as a prognostic factor in lung cancer survival supports previous research suggesting a direct biologic effect of smoking on survival. However, this effect may vary by sex and type of lung cancer.