Smoking and the course of prostate cancer

January 01, 0001

Smoking and the course of prostate cancer

Smoking has been linked to several cancers, but there is little date on smoking and its effect of the course of prostate cancer. These US researchers examined cigarette smoking and mortality and recurrence in prostate cancer patients. They performed a prospective observational study of 5366 men diagnosed with prostate cancer in the Health Professionals Follow-Up Study. Recurrence was defined as an increase in prostate-specific antigen (PSA) levels.

The researchers found: "There were 1630 deaths, 524 (32%) due to prostate cancer and 416 (26%) to CVD, and 878 biochemical recurrences. Absolute crude rates for prostate cancer-specific death for never vs current smokers were 9.6 vs 15.3 per 1000 person-years. For all-cause mortality, the corresponding rates were 27.3 and 53.0 per 1000 person-years. In multivariable analysis, current vs never smokers had an increased risk of prostate cancer mortality (HR, 1.61), as did current smokers with clinical stage T1 through T3 (HR, 1.80). Current smokers also had increased risk of biochemical recurrence (HR, 1.61), total mortality (HR, 2.28), and CVD mortality (HR, 2.13). After adjusting for clinical stage and grade… current smokers had increased risk of prostate cancer mortality (HR, 1.38), as did current smokers with clinical stage T1 through T3 (HR, 1.41). They also had an increased risk of biochemical recurrence (HR, 1.47). Greater number of pack- years was associated with significantly increased risk of prostate cancer mortality but not biochemical recurrence. Current smokers of 40 or more pack- years vs never smokers had increased prostate cancer mortality (HR, 1.82) and biochemical recurrence (HR, 1.48). Compared with current smokers, those who had quit smoking for 10 or more years (HR, 0.60) or who have quit for less than 10 years but smoked less than 20 pack-years (HR, 0.64) had prostate cancer mortality risks similar to never smokers (HR, 0.61)."

The researchers concluded: "Smoking at the time of prostate cancer diagnosis is associated with increased overall and CVD mortality and prostate cancer-specific mortality and recurrence. Men who have quit for at least 10 years have prostate cancer-specific mortality risks similar to those who have never smoked."

Smoking in prostate cancer patients is linked to higher mortality, including from prostate cancer, as well as higher risk of recurrence.

For the full abstract, click here.

JAMA 305(24):2548-2555, 8 June 2011 © 2011 American Medical Association
Smoking and Prostate Cancer Survival and Recurrence. Stacey A. Kenfield, Meir J. Stampfer, June M. Chan, Edward Giovannucci.

Category: U. Urinary System. Keywords: prostate cancer, smoking, cigarette, mortality, recurrence, prospective observational study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 12 July 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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