Smoking at breast cancer diagnosis linked to higher mortality risk among Black women
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Key findings:
- A study of 1,926 Black female breast cancer survivors showed those who smoked at the time of breast cancer diagnosis had a 52% increased risk for all-cause mortality compared with never-smokers.
- The increased risk appeared most pronounced among women with 10 or more pack-years of smoking.
Black women who smoked at the time of breast cancer diagnosis had a 52% increased risk for all-cause mortality compared with Black women who never smoked, according to study results published in JAMA Network Open.
Researchers observed an especially higher risk among women with greater pack-years of smoking and among those who regularly consumed alcohol, researchers noted.
Rationale and methods
Limited data exist on how lifestyle factors are associated with breast cancer prognosis among Black women because most of the evidence is based on studies of white breast cancer survivors, Nur Zeinomar, PhD, MPH, associate member of the cancer prevention and control program at Rutgers Cancer Institute, told Healio.
“Having a healthy lifestyle that includes limited alcohol consumption and not smoking has been associated with improved survival following a breast cancer diagnosis,” Zeinomar said.
For this reason, researchers sought to assess the association between prediagnostic cigarette smoking and alcohol consumption and all-cause and breast cancer-specific mortality among 1,926 Black female breast cancer survivors (mean age, 54.4 years) across 10 counties in New Jersey who had been diagnosed between June 6, 2005, and May 21, 2019.
Researchers conducted in-person interviews that inquired about smoking status at the time of breast cancer diagnosis, smoking duration and intensity, number of pack-years smoking and regular alcohol consumption within 1 year before breast cancer diagnosis.
Breast cancer-specific mortality and all-cause mortality served as primary outcomes.
Median follow-up was 6.7 years.
Results
Overall, 337 deaths occurred during 13,464 person-years of follow-up. Among them, 55.5% were breast cancer-associated deaths.
Results showed women who smoked at the time of breast cancer diagnosis had a 52% increased risk for all-cause mortality (HR = 1.52; 95% CI, 1.15-2.02) compared with never-smokers. The increased risk appeared most pronounced among women with 10 or more pack-years of smoking (HR = 1.84; 95% CI, 1.34-2.53).
Researchers additionally observed a similar but nonsignificant association for breast cancer-specific mortality between current vs. never-smokers (HR = 1.27; 95% CI, 0.87-1.85).
Among those who consumed more than three drinks per week vs. nondrinkers, researchers did not observe a significant association between alcohol consumption and all-cause mortality (HR = 1.05; 95% CI, 0.73-1.51) or breast cancer-specific mortality (HR = 1.06; 95% CI, 0.67-1.67).
Study limitations included limited data on postdiagnosis smoking and alcohol consumption and potential underreporting.
Implications
The findings add to the evidence on the detrimental health effects of smoking and underscore the need for tailored and targeted survivorship care for breast cancer survivors, particularly for women with heavier levels of smoking, Zeinomar told Healio.
“Our study further highlights the importance of avoiding smoking not only for cancer prevention but for better prognosis after a breast cancer diagnosis,” she said. “Future studies should examine the role of continued smoking after a cancer diagnosis, as well as smoking cessation in breast cancer survivorship.”
References:
- Investigators explore impact of cigarette smoking and alcohol consumption on Black breast cancer survivors (press release). Published Jan. 24, 2023. Accessed Jan. 24, 2023.
- Zeinomar N, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2022.52371.
For more information:
Nur Zeinomar, PhD, MPH, can be reached at nz171@cinj.rutgers.edu.
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