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Breast Cancer Res Treat (2015) 150:395403 DOI 10.1007/s10549-015-3317-3
EPIDEMIOLOGY
Smoking and survival in female breast cancer patients
Alicia Padron-Monedero Stacey L. Tannenbaum
Tulay Koru-Sengul Feng Miao Damien Hansra
David J. Lee Margaret M. Byrne
Received: 17 February 2015 / Accepted: 19 February 2015 / Published online: 28 February 2015 Springer Science+Business Media New York 2015
Abstract The purpose of this study was to determine if smoking affects survival in female breast cancer patients, both overall and stratied by race, ethnicity, and socioeconomic status. We linked data from the 19962007 Florida cancer data system, the Florida Agency for Health Care Administration, and the U.S. census. Inclusion criteria were females C18 years, diagnosed with breast cancer, and residing in Florida (n = 127,754). To analyze the association between smoking and survival, we performed sequential multivariate Cox proportional hazard regression models with progressive adjustment for main confounders. Compared to never smokers, worse survival was found in current (hazard ratio 1.33; 95 % CI 1.281.38) and former smokers (1.09; 1.061.13). Those who smoked \1, 12, and[2 packs/day had worse survival (HR 1.28; 1.201.36;
HR 1.40; 1.331.47 and 1.70; 1.451.99, respectively) (p for linear trend \0.001), than never smokers. Among
Whites, current and former smokers had worse survival (HR 1.38; 1.331.44 and HR 1.11; 1.071.15, respectively) than never smokers. Worse survival was also found for current and former smokers (HR 1.34; 1.291.40 and HR1.10; 1.061.15, respectively) compared with never
smokers among non-Hispanics; similarly, worse survival was found among current Hispanic smokers (HR 1.13;1.011.26). The association was not signicant for Blacks. Current smoking is associated with worse survival in White breast cancer patients and through all socioeconomic status categories and ethnicities compared to never smoking. Former smoking is associated with worse survival in White and non-Hispanic females. Blacks had similar survival regardless of smoking status. Nonetheless, all female breast cancer patients should be advised to quit smoking.
Keywords Female breast cancer Smoking Survival
Health inequalities
AbbreviationsSES Socioeconomic statusFCDS Florida cancer data systemAHCA Agency for Health Care Administration HR Hazard ratioCI Condence interval
A. Padron-Monedero T. Koru-Sengul D. Hansra
D. J. Lee M. M. Byrne
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
A. Padron-Monedero (&)
Department of Epidemiology, Comunidad de Madrid, Madrid, Spaine-mail:...