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Smoking & Cancer Stage at Diagnosis

ABSTRACT: Impact of Smoking on Cancer Stage at Diagnosis

Background: Studies evaluating the relationship between smoking and cancer spread are limited.

Results: In a tumor registry for eastern North Dakota, northwestern Minnesota, and northern South Dakota, 11,716 cases were identified from 1986 to 2001.

Current smokers (relative risk [RR], 2.11; 95% confidence interval, 1.93 to 2.32; P < .001) and previous smokers (RR, 1.56; 95% confidence interval, 1.42 to 1.72; P < 001) had an increased risk of metastatic disease at diagnosis. Current smokers (RR, 1.39; 95% confidence interval, 1.29 to 1.51; P < .001), but not previous smokers, also had an increased risk of regional disease.

An increase in metastatic disease was most evident for prostate cancer (RR, 1.53; P = .003). An increase in regional disease was most evident for head and neck (RR, 3.53; P < .001), prostate (RR, 1.83; P = .030), and breast cancer (RR, 1.22; P = .005).

Compared with previous smokers, current smokers with metastatic lung cancer were more likely to have involvement of the brain (33.6% v 23.0%; P = .004), bone marrow, adrenal gland, and pericardium (24.7% v 15.9%; P = .004).

Conclusion: Previous or current smoking is a risk factor for increased cancer stage in a wide range of malignancies.

Further study is required to determine whether this association is causal.

[02/28/2003; Journal of Clinical Oncology]

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