Jette Heberg1, Mette Kildevæld Simonsen2, Thordis Thomsen3, Vibeke Zoffmann4, Anne Kjaergaard Danielsen5. 1. Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark. Electronic address: jetteheberg@gmail.com. 2. The Parker Institute, Bispebjerg and Frederiksbergs Hospital, Region H, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark; Aarhus University, Health, Department of Public Health, Vennelyst, Boulevard 4, 8000, Aarhus C, Denmark. 3. Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark. 4. Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; University of Copenhagen, IFSV, Section of Health Services Research, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark. 5. Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.
Abstract
PURPOSE: To explore smoking cessation between cancer survivors and cancer-free women, and the potential survival benefits from smoking cessation in cancer surviving women. METHOD: We pooled 46,334 responses from the Danish Nurse Cohort. The cohort consists of female nurses, who were invited for surveys in 1993, 1999 and 2009. Participants were linked to nationwide registries on hospitalization, cause of death and migration through 2016. Odds for smoking cessation by cancer diagnosis were computed in propensity score matched logistic regression models, while survival by postdiagnosis smoking cessation was estimated in cox proportional hazards models. RESULTS: Eligible for analysis were 7841 women (mean age = 56.7 years, SD ± 7.2), who were smokers at baseline and survived to the next follow-up survey. Of these, 545 women were diagnosed with cancer and matched by propensity score (1:2) with 1090 cancer-free women. Odds for smoking cessation were significantly higher in cancer-diagnosed women compared to their cancer-free peers (OR = 1.31, 95% CI: 1.06-1.61). Moreover, mortality risk was significantly lower among cancer survivors who stopped smoking (HR = 0.64, 95% CI: 0.46-0.91), compared to persistent smokers. CONCLUSIONS: The results suggest considerable survival benefits from smoking cessation in cancer surviving female nurses, and that the time surrounding cancer diagnosis may serve as a teachable moment for smoking cessation. However, due to substantial methodological limitations embedded in the study, careful interpretation of the presented results is warranted. Future studies are needed to demonstrate the effects of diagnosis on smoking cessation as well as the effects of smoking cessation on survival in female cancer populations.
PURPOSE: To explore smoking cessation between cancer survivors and cancer-free women, and the potential survival benefits from smoking cessation in cancer surviving women. METHOD: We pooled 46,334 responses from the Danish Nurse Cohort. The cohort consists of female nurses, who were invited for surveys in 1993, 1999 and 2009. Participants were linked to nationwide registries on hospitalization, cause of death and migration through 2016. Odds for smoking cessation by cancer diagnosis were computed in propensity score matched logistic regression models, while survival by postdiagnosis smoking cessation was estimated in cox proportional hazards models. RESULTS: Eligible for analysis were 7841 women (mean age = 56.7 years, SD ± 7.2), who were smokers at baseline and survived to the next follow-up survey. Of these, 545 women were diagnosed with cancer and matched by propensity score (1:2) with 1090 cancer-free women. Odds for smoking cessation were significantly higher in cancer-diagnosed women compared to their cancer-free peers (OR = 1.31, 95% CI: 1.06-1.61). Moreover, mortality risk was significantly lower among cancer survivors who stopped smoking (HR = 0.64, 95% CI: 0.46-0.91), compared to persistent smokers. CONCLUSIONS: The results suggest considerable survival benefits from smoking cessation in cancer surviving female nurses, and that the time surrounding cancer diagnosis may serve as a teachable moment for smoking cessation. However, due to substantial methodological limitations embedded in the study, careful interpretation of the presented results is warranted. Future studies are needed to demonstrate the effects of diagnosis on smoking cessation as well as the effects of smoking cessation on survival in female cancer populations.
Keywords:
Cancer; Cancer survivors; Health promotion; Life style; Oncology care; Prevention and control; Risk factors; Smoking cessation; Tertiary prevention; Women