Smoking, drinking postdiagnosis decreased head and neck cancer survival

Among patients diagnosed with head and neck cancers, smoking cigarettes and drinking beer and liquor both pre- and postdiagnosis reduced survival.

Researchers conducted a randomized, controlled trial to determine if smoking and drinking pre- and postdiagnosis was associated with survival in patients with head and neck cancers. They examined data from 264 patients from 49 hospitals in Connecticut and Florida from January 1991 to June 1998. Average follow-up was 4.2 years.

During follow-up, 62 deaths occurred; 35 were due to cancer; 18, to cardiovascular disease; nine, to other causes.

Those who smoked at the time of diagnosis were at a 4.9-fold (95% CI, 0.7-36.0) higher risk for death when compared with nonsmokers. Patients who had more than 60 pack-years of smoking at diagnosis had a 5.4-fold (95% CI, 0.7-40.1) greater risk for death than nonsmokers.

Those who continuously smoked during follow-up were at increased risk for death. When adjusted for age, those who kept smoking had a 3.3-fold (95% CI, 1.74-6.26) elevated risk for death. When further adjusted for smoking history, alcohol use and other covariates, the association between smoking and risk for death remained but lost statistical significance.

Patients who drank more than 35 drinks per week before diagnosis had a 4.9-fold (95% CI, 1.5-16.3) increase in risk for death compared with those who did not drink.

Postdiagnosis, the risk for death increased for those who continued to drink vs. those who did not. Risk for death was linked to drinking in adjusted and unadjusted analyses.

“Effective smoking and alcohol interventions will not only prevent second primary tumors but are also expected to improve OS in these patients,” the researchers said.

Mayne ST. Cancer Epidemiol Biomarkers Prev. 2009;doi:10.1158/1055-9965.EPI-09-0944.