Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis: a meta-analysis of individual patient data from cohorts within the CHANCES consortium
Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited.
For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12,414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology.
A total of 5,229 participants died, 3,194 from CRC. Cox regression revealed significant associations between former (hazard ratio (HR)=1.12; 95%-confidence interval (CI)=1.04-1.20) and current smoking (HR = 1.29; 95%CI=1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR<10years=0.78; 95%CI=0.69-0.88; HR≥10years=0.78; 95%CI=0.63-0.97) and CRC-specific survival (HR≥10years=0.76; 95%CI=0.67-0.85).
In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of non-smoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.
Pharmacology, Toxicology and Pharmaceutical Science
4
3%
Other
14
9%
Unknown
77
51%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 January 2020.
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#2,687,933
of 34,762,862 outputs
Outputs from Annals of Oncology
#1,694
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Outputs of similar age
#46,667
of 495,684 outputs
Outputs of similar age from Annals of Oncology
#52
of 169 outputs
Altmetric has tracked 34,762,862 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,417 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.4. This one has done well, scoring higher than 83% of its peers.
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We're also able to compare this research output to 169 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
