Dataset Information

Association between duration of smoking abstinence before non-small-cell lung cancer diagnosis and survival: a retrospective, pooled analysis of cohort studies.

ABSTRACT:

Background

The association between duration of smoking abstinence before non-small-cell lung cancer (NSCLC) diagnosis and subsequent survival can influence public health messaging delivered in lung-cancer screening. We aimed to assess whether the duration of smoking abstinence before diagnosis of NSCLC is associated with improved survival.

Methods

In this retrospective, pooled analysis of cohort studies, we used 26 cohorts participating in Clinical Outcomes Studies of the International Lung Cancer Consortium (COS-ILCCO) at 23 hospitals. 16 (62%) were from North America, six (23%) were from Europe, three (12%) were from Asia, and one (4%) was from South America. Patients enrolled were diagnosed between June 1, 1983, and Dec 31, 2019. Eligible patients had smoking data before NSCLC diagnosis, epidemiological data at diagnosis (obtained largely from patient questionnaires), and clinical information (retrieved from medical records). Kaplan-Meier curves and multivariable Cox models (ie, adjusted hazard ratios [aHRs]) were generated with individual, harmonised patient data from the consortium database. We estimated overall survival for all causes, measured in years from diagnosis date until the date of the last follow-up or death due to any cause and NSCLC-specific survival.

Findings

Of 42 087 patients with NSCLC in the COS-ILCCO database, 21 893 (52·0%) of whom were male and 20 194 (48·0%) of whom were female, we excluded 4474 (10·6%) with missing data. Compared with current smokers (15 036 [40·0%] of 37 613), patients with 1-3 years of smoking abstinence before NSCLC diagnosis (2890 [7·7%]) had an overall survival aHR of 0·92 (95% CI 0·87-0·97), patients with 3-5 years of smoking abstinence (1114 [3·0%]) had an overall survival aHR of 0·90 (0·83-0·97), and patients with more than 5 years of smoking abstinence (10 841 [28·8%]) had an overall survival aHR of 0·90 (0·87-0·93). Improved NSCLC-specific survival was observed in 4301 (44%) of 9727 patients who had quit cigarette smoking and was significant at abstinence durations of more than 5 years (aHR 0·87, 95% CI 0·81-0·93). Results were consistent across age, sex, histology, and disease-stage distributions.

Interpretation

In this large, pooled analysis of cohort studies across Asia, Europe, North America, and South America, overall survival was improved in patients with NSCLC whose duration of smoking abstinence before diagnosis was as short as 1 year. These findings suggest that quitting smoking can improve overall survival, even if NSCLC is diagnosed at a later lung-cancer screening visit. These findings also support the implementation of public health smoking cessation strategies at any time.

Funding

The Alan B Brown Chair, The Posluns Family Fund, The Lusi Wong Fund, and the Princess Margaret Cancer Foundation.

SUBMITTER: Fares AF

PROVIDER: S-EPMC10540150 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Association between duration of smoking abstinence before non-small-cell lung cancer diagnosis and survival: a retrospective, pooled analysis of cohort studies.

Fares Aline F AF Li Yao Y Jiang Mei M Brown M Catherine MC Lam Andrew C L ACL Aggarwal Reenika R Schmid Sabine S Leighl Natasha B NB Shepherd Frances A FA Wang Zhichao Z Diao Nancy N Wenzlaff Angela S AS Xie Juntao J Kohno Takashi T Caporaso Neil E NE Harris Curtis C Ma Hongxia H Barnett Matthew J MJ Leal Leticia Ferro LF Fernandez-Tardon G G Pérez-Ríos Mónica M Davies Michael P A MPA Taylor Fiona F Schöttker Ben B Brennan Paul P Zaridze David D Holcatova Ivana I Lissowska Jolanta J Świątkowska Beata B Mates Dana D Savic Milan M Brenner Hermann H Andrew Angeline A Cox Angela A Field John K JK Ruano-Ravina Alberto A Shete Sanjay S SS Tardon Adonina A Wang Ying Y Le Marchand Loic L Reis Rui Manuel RM Schabath Matthew B MB Chen Chu C Shen Hongbing H Ryan Brid M BM Landi Maria Teresa MT Shiraishi Kouya K Zhang Jie J Schwartz Ann G AG Tsao Ming S MS Christiani David C DC Yang Ping P Hung Rayjean J RJ Xu Wei W Liu Geoffrey G

The Lancet. Public health 20230901 9

<h4>Background</h4>The association between duration of smoking abstinence before non-small-cell lung cancer (NSCLC) diagnosis and subsequent survival can influence public health messaging delivered in lung-cancer screening. We aimed to assess whether the duration of smoking abstinence before diagnosis of NSCLC is associated with improved survival.<h4>Methods</h4>In this retrospective, pooled analysis of cohort studies, we used 26 cohorts participating in Clinical Outcomes Studies of the Internat ...[more]

PMID: 37633678

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Dataset Information

Association between duration of smoking abstinence before non-small-cell lung cancer diagnosis and survival: a retrospective, pooled analysis of cohort studies.

Background

Methods

Findings

Interpretation

Funding

Publications

Association between duration of smoking abstinence before non-small-cell lung cancer diagnosis and survival: a retrospective, pooled analysis of cohort studies.

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