Numerous trials have linked cigarette smoking to increased risk of prostate cancer mortality. Smoking is associated with a 30% increase in fatal prostate cancer due to more aggressive disease. The aim of this study was to assess the relationship between smoking and smoking cessation with overall, prostate cancer-specific, and cardiovascular mortality, as well as biochemical recurrence in men with prostate cancer.
The Health Professionals Follow-Up Study enrolled over 51,000 male health professionals, and smoking status was asked every 2 years since 1986. Men included in the study were free of prostate cancer during recruitment. This study evaluated 5366 men who had been diagnosed with prostate cancer between 1986 and 2006.
Outcomes of this study revealed that 32% of men died from prostate cancer, and 26% due to cardiovascular disease. Smokers had an increased risk of prostate cancer (hazard ratio [HR] = 1.61) as well as biochemical recurrence (HR = 1.61), cardiovascular mortality (HR = 2.13) and total mortality (HR = 2.28). Greater numbers of pack-years of smoking were directly associated with increased risk of prostate cancer but not biochemical recurrence.
In conclusion, smoking at the time of prostate cancer diagnosis was associated with increased mortality due all of the aforementioned causes. Men who quit smoking for at least 10 years were found to have mortality specifically due to prostate cancer at similar rates compared to men who had never smoked.
References: Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E. Smoking and prostate cancer survival and recurrence. JAMA 2011;305(24):2548-2555.