Prediagnosis Smoking Cessation and Overall Survival Among Patients With Non-Small Cell Lung Cancer

Lung cancer remains the leading cause of cancer-related death globally; non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer cases, and cigarette smoking is the factor most significantly associated with its risk. However, little is known about the association of years since prediag...

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Bibliographic Details
Published in:JAMA network open 2023-05, Vol.6 (5), p.e2311966
Main Authors: Wang, Xinan, Romero-Gutierrez, Christopher W, Kothari, Jui, Shafer, Andrea, Li, Yi, Christiani, David C
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Non-Small-Cell Lung - epidemiology
Cohort analysis
Cohort Studies
Humans
Lung cancer
Lung Neoplasms
Male
Medical diagnosis
Medical prognosis
Mortality
Oncology
Online Only
Original Investigation
Proportional Hazards Models
Smoking Cessation
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Summary:Lung cancer remains the leading cause of cancer-related death globally; non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer cases, and cigarette smoking is the factor most significantly associated with its risk. However, little is known about the association of years since prediagnosis smoking cessation and cumulative smoking with overall survival (OS) following a lung cancer diagnosis. To characterize the association of years since smoking cessation before diagnosis and cumulative smoking pack-years with OS in patients with NSCLC in a lung cancer survivor cohort. The cohort study involved patients with NSCLC who were recruited to the Boston Lung Cancer Survival Cohort at Massachusetts General Hospital (Boston, Massachusetts) between 1992 and 2022. Patients' smoking history and baseline clinicopathological characteristics were prospectively collected through questionnaires, and OS following lung cancer diagnosis was regularly updated. Duration of smoking cessation before a lung cancer diagnosis. The primary outcome was the association of detailed smoking history with OS following a lung cancer diagnosis. Of 5594 patients with NSCLC (mean [SD] age, 65.6 [10.8] years; 2987 men [53.4%]), 795 (14.2%) were never smokers, 3308 (59.1%) were former smokers, and 1491 (26.7%) were current smokers. Cox regression analysis suggested that former smokers had 26% higher mortality (hazard ratio [HR], 1.26; 95% CI, 1.13-1.40; P 
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2023.11966