Background
- Previous studies have shown that smoking increases cancer-specific and all-cause mortality in women with breast cancer.
- However, the benefits of smoking cessation in women with breast cancer are controversial.
Insight
- Among women with breast cancer, smokers had a 22%-25% higher risk of cancer-specific mortality or mortality compared to non-smokers.All-cause mortality. This result corresponds in magnitude to that of previous studies.
- According to of this population-based, retrospective, real-world cohort study from Taiwan, women smokers have a 57% higher risk of death than those who quit.
Why this matters
- This is one of the first studies of its kind in Asian women with breast cancer.
- GPs and specialists should encourage women with breast cancer who smoke to participate in smoking cessation programmes.
Study design
- Population-based, retrospective, real-world cohort study in Taiwan with 54,614 women newly diagnosed with breast cancer (2011-2017) and registered in the Taiwanese Cancer Registry.
- Several databases were used in the study to assess the effects of smoking and smoking.of quitting smoking for the risk of death.
- Primary endpoints: All-cause mortality and cancer-specific mortality using Taiwan’s Causes of Death database.
- The study also examined the effects of various traits such as comorbidities, alcohol use and treatment types on primary endpoints.
- Funding: Ministry of Health and Welfare, Taiwan; Chi Mei Medical Center.
Key findings
- The total cohort of 54,614 women with newly diagnosed breast cancer consisted of 1687 current or former smokers and 52,927 non-smokers.
- Compared to non-smoking women with breast cancer, women with breast cancer who smoked (current or previously) had a 25% higher risk of all-cause mortality (aHR 1.25; 95% CI 1.08-1.45) and a 22% higher risk of cancer-specific mortality (aHR 1.22; 95% CI 1.04-1.44). The hazard ratio (HR) is an estimate of the mortality rate in the group of smokers compared to the group of non-smokers.An adjusted HR tries to exclude disruptive factors. The 95% confidence interval (AI) is the range of values in which HR is with a probability of error of only 5%. An AI that includes 1.0 as non-significant and an AI that does not contain 1.0 as significant.
- Data were adjusted for age, clinical stage, alcohol consumption, betel nut chewing, comorbidities, BMI, and treatment types. These adjustments are intended to prevent distortion of the results by disruptive factors.
- In the women without comorbidities, the stratified analysis showed a 20% higher overall mortality risk for women with breast cancer who smoked (current or previously; HR 1.20; 95% CI 1.01-1.43), but no significant difference in cancer-specific mortality (HR 1.11; 95% CI 0.91-1.35).
- Women with breast cancer who currently smoked had a 57% higher risk of all-cause mortality than women who quit smoking (aHR 1.57; 95% CI 1.02-2.42), but no significant difference in cancer-specific mortality was found (aHR 1.48; 95% CI 0.91-2.40).
- In the stratified analysis of quitting data, current smokers (compared to those who had quit) showed:
- When drinking alcohol, the risk of all-cause mortality was more than three times higher (aHR 3.08; 95% CI 1.38-6.85).
- Without comorbidities, a twice the risk of all-cause mortality (aHR 2.01; 95% CI 1.12-3.61).
- The risk of all-cause mortality is more than three times higher when receiving radiotherapy (aHR 3.05; 95% CI 1.39-6.69).
- Data were adjusted for age, clinical stage, alcohol consumption, betel nut chewing, comorbidities, BMI, and treatment types. These adjustments are intended to prevent distortion of the results by disruptive factors.
- When drinking alcohol, the risk of all-cause mortality was more than three times higher (aHR 3.08; 95% CI 1.38-6.85).
- Without comorbidities, a twice the risk of all-cause mortality (aHR 2.01; 95% CI 1.12-3.61).
- The risk of all-cause mortality is more than three times higher when receiving radiotherapy (aHR 3.05; 95% CI 1.39-6.69).
Restrictions
- Retrospective observational design.
- The results may be limited to Asian populations.
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Source — https://www.univadis.de/viewarticle/rauchstopp-senkt-die-sterblichkeit-von-frauen-mit-brustkrebs
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