This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kobrinsky, N. L. Articles by Burd, L. Search for Related Content PubMed PubMed Citation Articles by Kobrinsky, N. L. Articles by Burd, L.

Impact of Smoking on Cancer Stage at Diagnosis

Nathan L. Kobrinsky, Marilyn G. Klug, Peggy Jo Hokanson, Diane E. Sjolander, Larry Burd

From the Roger Maris Cancer Center; Department of Pediatrics, MeritCare Children’s Hospital, Fargo; Department of Pediatrics, Faculty of Medicine, University of North Dakota, Fetal Alcohol Syndrome Center, Grand Forks, ND.

Address reprint requests to Nathan Kobrinsky, MD, 820 4th St. North, Fargo, ND 58122, email: nathankobrinsky{at}meritcare.com.

Background: Studies evaluating the relationship between smoking and cancer spread are limited.

Methods: We studied the relationship between cancer stage at diagnosis (local, regional, or metastatic) and smoking history (current, previous, or nonsmoker). For lung cancer, patterns of spread were also studied.

Results: In a tumor registry for eastern North Dakota, northwestern Minnesota, and northern South Dakota, 11,716 cases were identified from 1986 to 2001. Current smokers (relative risk [RR], 2.11; 95% confidence interval, 1.93 to 2.32; P < .001) and previous smokers (RR, 1.56; 95% confidence interval, 1.42 to 1.72; P < .001) had an increased risk of metastatic disease at diagnosis. Current smokers (RR, 1.39; 95% confidence interval, 1.29 to 1.51; P < .001), but not previous smokers, also had an increased risk of regional disease. An increase in metastatic disease was most evident for prostate cancer (RR, 1.53; P = .003). An increase in regional disease was most evident for head and neck (RR, 3.53; P < .001), prostate (RR, 1.83; P = .030), and breast cancer (RR, 1.22; P = .005). Compared with previous smokers, current smokers with metastatic lung cancer were more likely to have involvement of the brain (33.6% v 23.0%; P = .004), bone marrow, adrenal gland, and pericardium (24.7% v 15.9%; P = .004).

Conclusion: Previous or current smoking is a risk factor for increased cancer stage in a wide range of malignancies. Further study is required to determine whether this association is causal.

Supported by the Roger Maris Cancer Center, MeritCare Children’s Hospital, and the Children’s Miracle Network, Fargo, ND.

This article has been cited by other articles:

				N. L. Nock, X. Liu, M. S. Cicek, L. Li, F. Macarie, B. A. Rybicki, S. J. Plummer, G. T. MacLennan, G. Casey, and J. S. Witte Polymorphisms in polycyclic aromatic hydrocarbon metabolism and conjugation genes, interactions with smoking and prostate cancer risk. Cancer Epidemiol. Biomarkers Prev., April 1, 2006; 15(4): 756 - 761. [Abstract] [Full Text] [PDF]

				T. Kosaka, Y. Yatabe, H. Endoh, H. Kuwano, T. Takahashi, and T. Mitsudomi Mutations of the Epidermal Growth Factor Receptor Gene in Lung Cancer: Biological and Clinical Implications Cancer Res., December 15, 2004; 64(24): 8919 - 8923. [Abstract] [Full Text] [PDF]