23 juni 2011: Bron JAMA

Mannen die rookten voor en op het moment van de diagnose prostaatkanker te hebben, hebben beduidend meer kans op overlijden aan hun prostaatkanker, o.a. door hartfalen welke direct is gerelateerd aan prostaatkanker dan niet rokers. En deze mannen hebben ook grotere kans op een recidief na een behandeling in vergelijking met mannen die niet rookten. Hoe meer de man met prostaatkanker had gerookt of bleef roken hoe slechter de prognose was. Dit blijkt uit een 20 jarige studie met 5366 mannen die te horen kregen dat zij prostaatkanker hadden. De onderzoekers zeggen dat zij niet expliciet hebben onderzocht of tussentijds stoppen met roken effect had, maar dat wel bleek dat wie 10 jaar lang niet had gerookt voor de diagnose de prognose gelijk bleek aan de mannen die niet hadden gerookt. Alsnog stoppen zou dus effect kunnen hebben, maar is in deze studie niet expliciet onderzocht.

Hier het abstract van de studie gepubliceerd in JAMA

Smoking linked to higher prostate cancer mortality and recurrence

Smoking and Prostate Cancer Survival and Recurrence

  1. Stacey A. Kenfield, ScD;
  2. Meir J. Stampfer, MD, DrPH;
  3. June M. Chan, ScD;
  4. Edward Giovannucci, MD, ScD

[+] Author Affiliations

  1. Author Affiliations: Departments of Epidemiology (Drs Kenfield, Stampfer, and Giovannucci) and Nutrition (Drs Stampfer and Giovannucci), Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (Drs Kenfield, Stampfer, and Giovannucci), Boston, Massachusetts; and Departments of Epidemiology & Biostatistics and Urology, University of California, San Francisco (Dr Chan).

Abstract

Context Studies of smoking in relation to prostate cancer mortality or recurrence in prostate cancer patients are limited, with few prostate cancer–specific outcomes.

Objective To assess the relation of cigarette smoking and smoking cessation with overall, prostate cancer–specific, and cardiovascular disease (CVD) mortality and biochemical recurrence among men with prostate cancer.

Design, Setting, and Participants Prospective observational study of 5366 men diagnosed with prostate cancer between 1986 and 2006 in the Health Professionals Follow-Up Study.

Main Outcome Measures Hazard ratios (HRs) for overall, prostate cancer–specific, and CVD mortality, and biochemical recurrence, defined by an increase in prostate-specific antigen (PSA) levels.

Results There were 1630 deaths, 524 (32%) due to prostate cancer and 416 (26%) to CVD, and 878 biochemical recurrences. Absolute crude rates for prostate cancer–specific death for never vs current smokers were 9.6 vs 15.3 per 1000 person-years; for all-cause mortality, the corresponding rates were 27.3 and 53.0 per 1000 person-years. In multivariable analysis, current vs never smokers had an increased risk of prostate cancer mortality (HR, 1.61; 95% confidence interval , 1.11-2.32), as did current smokers with clinical stage T1 through T3 (HR, 1.80; 95% CI, 1.04-3.12). Current smokers also had increased risk of biochemical recurrence (HR, 1.61; 95% CI, 1.16-2.22), total mortality (HR, 2.28; 95% CI, 1.87-2.80), and CVD mortality (HR, 2.13; 95% CI, 1.39-3.26). After adjusting for clinical stage and grade (likely intermediates of the relation of smoking with prostate cancer recurrence and survival), current smokers had increased risk of prostate cancer mortality (HR, 1.38; 95% CI, 0.94-2.03), as did current smokers with clinical stage T1 through T3 (HR, 1.41; 95% CI, 0.80-2.49); they also had an increased risk of biochemical recurrence (HR, 1.47; 95% CI, 1.06-2.04). Greater number of pack-years was associated with significantly increased risk of prostate cancer mortality but not biochemical recurrence. Current smokers of 40 or more pack-years vs never smokers had increased prostate cancer mortality (HR, 1.82; 95% CI, 1.03-3.20) and biochemical recurrence (HR, 1.48; 95% CI, 0.88-2.48). Compared with current smokers, those who had quit smoking for 10 or more years (HR, 0.60; 95% CI, 0.42-0.87) or who have quit for less than 10 years but smoked less than 20 pack-years (HR, 0.64; 95% CI, 0.28-1.45) had prostate cancer mortality risks similar to never smokers (HR, 0.61; 95% CI, 0.42-0.88).

Conclusions Smoking at the time of prostate cancer diagnosis is associated with increased overall and CVD mortality and prostate cancer–specific mortality and recurrence. Men who have quit for at least 10 years have prostate cancer–specific mortality risks similar to those who have never smoked.


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Reageer op "Algemeen: Rokers hebben grotere kans te overlijden aan prostaatkanker en aan prostaatkanker gerelateerd hartfalen en een grotere kans op een recidief na een behandeling dan niet rokers blijkt uit een 20 jarige studie bij 5366 mannen met prostaatkanker."


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