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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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