Prospective cohort of pre- and post-diagnosis alcohol consumption and cigarette smoking on survival outcomes: an Alberta Endometrial Cancer Cohort Study.

Autor: Kokts-Porietis RL; Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada., Morielli AR; Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada., McNeil J; Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA., Benham JL; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Courneya KS; Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada., Cook LS; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Friedenreich CM; Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada. Christine.Friedenreich@albertahealthservices.ca.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Christine.Friedenreich@albertahealthservices.ca.; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Christine.Friedenreich@albertahealthservices.ca.
Jazyk: angličtina
Zdroj: Cancer causes & control : CCC [Cancer Causes Control] 2024 Jan; Vol. 35 (1), pp. 121-132. Date of Electronic Publication: 2023 Aug 19.
DOI: 10.1007/s10552-023-01777-w
Abstrakt: Purpose: To examine the independent and joint relationships between cigarette smoking and alcohol consumption with survival outcomes after endometrial cancer diagnosis.
Methods: Pre- and post-diagnosis smoking and drinking histories were obtained from endometrial cancer survivors diagnosed between 2002 and 2006 during in-person interviews at-diagnosis and at ~ 3 years post-diagnosis. Participants were followed until death or January 2022. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards regression for associations with disease-free survival (DFS) and overall survival (OS).
Results: During a median 16.9 years of follow-up (IQR = 15.5-18.1 years), 152 of the 540 participants had a DFS event (recurrence: n = 73; deaths: n = 79) and 134 died overall. Most participants in this cohort were current drinkers (pre = 61.3%; post = 64.7%) while few were current cigarette smokers (pre = 12.8%; post = 11.5%). Pre-diagnosis alcohol consumption was not associated with survival, yet post-diagnosis alcohol intake ≥ 2 drinks/week was associated with worse OS compared with lifetime abstention (HR = 2.36, 95%CI = 1.00-5.54) as well as light intake (HR = 3.87, 95% CI = 1.67-8.96). Increased/consistently high alcohol intake patterns were associated with worse OS (HR = 2.91, 95% CI = 1.15-7.37) compared with patterns of decreased/ceased intake patterns after diagnosis. A harmful dose-response relationship per each additional pre-diagnosis smoking pack-year with OS was noted among ever smokers. In this cohort, smoking and alcohol individually were not associated with DFS and combined pre-diagnosis smoking and alcohol intakes were not associated with either outcome.
Conclusion: Endometrial cancer survivors with higher alcohol intakes after diagnosis had poorer OS compared with women who had limited exposure. Larger studies powered to investigate the individual and joint impacts of cigarette smoking and alcohol use patterns are warranted to provide additional clarity on these modifiable prognostic factors.
(© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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