喫煙と前立腺がんの生存率と再発率
Stacey A Kenfield1, Meir J Stampfer, June M Chan
1Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA. skenfiel@hsph.harvard.edu
JAMA
|June 23, 2011
まとめ
診断時の喫煙は,前立腺がんの死亡率と再発のリスクを高めます. 10年以上禁煙すると,前立腺がんによる死亡リスクが大幅に低下し,決して喫煙していない人と同じです.
科学分野:
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 喫煙が前立腺がんの死亡率と再発に及ぼす影響に関する研究は限られている.
- 喫煙に関連する前立腺がん特異的なアウトカムに焦点を当てた研究はほとんどありません.
研究 の 目的:
- 前立腺がん患者の死亡率 (全体,前立腺がん特異的,心血管疾患) と生化学的再発とのタバコ喫煙と禁煙との関連性を評価する.
主な方法:
- 前立腺がんと診断された5366人の男性 (1986年~2006年) を対象とした展望的観察研究.
- 死亡率と生化学的再発 (PSAレベルによって定義される) について,危険比率 (HRs) を計算した.
主要な成果:
- 現在の喫煙者は,前立腺がんによる死亡率 (HR 1.61),生化学的再発率 (HR 1.61),全死亡率 (HR 2.28),心血管疾患による死亡率 (HR 2.13) のリスクが,決して喫煙していない人と比較して高かった.
- 40パック年以上の喫煙は前立腺がんによる死亡リスクを大幅に増加させた (HR1.82).
- 10年以上禁煙すると,前立腺がんによる死亡リスクは,決して喫煙していない人と同じレベル (HR 0.60) に低下します.
結論:
- 診断時の喫煙は,前立腺がん患者の死亡率と再発率の増加と関連しています.
- 少なくとも10年間禁煙すると,前立腺がんに特異的な死亡リスクが軽減され,決してタバコを吸わない人と同じレベルに達します.
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