SMOKING HISTORY AND CANCER-PATIENT SURVIVAL - A HOSPITAL CANCER REGISTRY STUDY

While tobacco use is clearly the most preventable cause of cancer, lit tle is known about whether smoking adversely influences cancer patient s' survival. The goal of this study was to examine the effect of smoki ng history on survival among cancer patients. Data from Memorial Sloan -Kettering Cancer Center's tumor registry was used to identify 25,436 cases of cancer (12,447 male patients and 12,989 female patients). Inf ormation regarding smoking and alcohol consumption, histologic grade, tumor stage, and survival time was available. Proportional hazard anal ysis was used to examine the effect of smoking on the death from all c auses among patients. Patients who had a history of smoking were found to have a lower rate of survival than nonsmokers. After controlling f or age, race, alcohol use, and histologic grade, the risk ratios were 1.55 for males and 1.43 for females. A dose-response relationship was found between ever-smoking and cancer patient survival. The predictive effect of smoking on survival was significant for patients with oral, pancreatic, breast, and prostate cancers, but not for esophageal, sto mach, colon, rectum, laryngeal, lung, cervix uteri, urinary bladder, a nd kidney cancers. Black patients with oral or boast cancer had a poor er prognosis associated with smoking compared with white and other non white patients. The strongest effect of smoking on survival was found mainly among patients with breast cancer with a distant tumor stage or with prostate cancer with a regional tumor stage. Alcohol use alone w as associated with a higher risk of death for nonsmokers with oral and pancreatic cancers than for similar cancer patients without a history of alcohol use. Smoking history plays a critical role in influencing cancer patient survival, especially for patients diagnosed with oral, pancreatic, breast, or prostatic cancers. In addition, alcohol consump tion is independently related to survival in patients with oral and pa ncreatic cancers. Our study suggests that a potential means of improvi ng cancer patient survival, especially from oral, pancreatic, breast, and prostatic cancers, may be achieved through smoking cessation.