Smoking cessation and survival in lung, upper aero-digestive tract and bladder cancer: cohort study

Background: The aim was to examine the association between smoking cessation and prognosis in smoking-related cancer as it is unclear that cessation reduces mortality.Methods: In this retrospective cohort study from 1999 to 2013, we assessed the association between cessation during the first year after diagnosis and all-cause and cancer- specific mortality.Results: Of 2,882 lung, 757 upper aero-digestive tract and 1,733 bladder cancer patients 27%, 29% and 21% of lung, UAT and bladder cancer patients quit smoking. In lung cancer patients that quit, all-cause mortality was significantly lower (HR 0.82 (0.74-0.92), while cancer-specific mortality (HR 0.89 (0.76-1.04) and death due to index cancer (HR 0.90 (0.77-1.05) were nonsignificantly lower. In UAT cancer, all-cause mortality (HR 0.81 (0.58-1.14), cancer-specific mortality (HR 0.84 (0.48-1.45), and death due to index cancer (HR 0.75 (0.42-1.34) were non-significantly lower. There was no evidence of an association between quitting and mortality in bladder cancer. The HRs were 1.02 (0.81 1.30) for all-cause, 1.23 (0.81-1.86) for cancer specific, and 1.25 (0.71-2.20) for death due to index cancer. These showed a nonsignificantly lower risk in sensitivity analyses.Conclusion: People with lung and possibly UAT cancer who quit smoking have a lower risk of mortality than people who continue smoking