Accuracy of Self-reported Smoking Exposure Among Bladder Cancer Patients Undergoing Surveillance at a Tertiary Referral Center

• Published in: European urology focus 2016-10, Vol.2 (4), p.441
• Main Authors: Thong, Alan E, Petruzella, Stacey, Orlow, Irene, Zabor, Emily C, Ehdaie, Behfar, Ostroff, Jamie S, Bochner, Bernard H, Furberg Barnes, Helena
• Format: Article
• Language: English
• ISSN: 2405-4569
• DOI: 10.1016/j.euf.2015.12.002

Smoking is a risk factor for developing bladder cancer (BCa). Even though continued exposure after diagnosis may adversely affect prognosis, patients may be reluctant to disclose to their physicians that they are currently smoking, leading to inaccurate reporting of exposure and missed opportunities to deliver smoking-cessation advice and treatment in the context of cancer care. We examined the extent of misclassification of recent smoking exposure among patients undergoing BCa surveillance. A consecutive sample of 145 patients with a self-reported smoking history and prior initial diagnosis of BCa was recruited from a tertiary referral urology clinic. Patients were asked if they had smoked a cigarette or used nicotine replacement therapy (NRT) within the past week and whether they lived with a smoker. At the same visit, we collected urine under a biospecimen protocol. We used urinary cotinine, the primary metabolite of nicotine, as an objective biomarker of recent smoking exposure. Nine patients whose urine could not be interpreted for cotinine were excluded. We calculated the smoking status misreporting rate by comparing biochemically verified smoking status (≥31.5 ng/ml vs