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 21 May 2018

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News

Smoking at diagnosis is an independent prognostic factor for colon cancer

Smoking at diagnosis significantly decreases 5-year cancer-specific survival in a population-based cohort of colon cancer patients, finds the latest issue of the Alimentary Pharmacology & Therapeutics.

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Accumulating evidence suggests smoking may adversely affect cancer patients’ outcomes. 

Previous studies of smoking and survival in colon cancer have been limited by size and/or lack of a population basis and results have been inconsistent.

Dr Sharp and colleagues from the United Kingdom investigated in a large population-based cohort whether smoking status at diagnosis is an independent prognostic factor for cancer-specific survival in colon cancer and whether treatment modifies any impact of smoking.

Colon adenocarcinomas diagnosed between 1994 and 2012 were abstracted from the National Cancer Registry Ireland, and classified by smoking status at diagnosis. 

20% of patients were current smokers
Alimentary Pharmacology & Therapeutics
Cancer-specific death rates over 5 years were compared in current, ex- and never smokers using multivariable Cox proportional hazards models, and subgroup analyses by treatment were conducted.

Of 18,166 colon cancers, the team found that 20% of patients were current smokers, 23% ex-smokers and 57% never smokers. 

Compared to never smokers, the researchers observed that current smokers had a significantly raised cancer death rate. 

The team noted a significant interaction between treatment and smoking. 

In those who had cancer-directed surgery only, but not other groups, current smokers had a significantly increased cancer death rate compared to never smokers.

Dr Sharp's team concludes, "Smoking at diagnosis is an independent prognostic factor for colon cancer."

"The limitation of the association to surgically-treated patients suggests that the underlying mechanism may be related to surgery."

"While further research is needed to elucidate mechanisms, continued efforts to encourage smoking prevention, and cessation may yield benefits in terms of improved survival from colon cancer."

Aliment Pharmacol Ther 2017: 45(6): 788–800 
28 February 2017

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