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Active smoking and survival following breast cancer among African American and non-African American women in the Carolina Breast Cancer Study

To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s10552-017-0923-x Byline: Humberto Parada (1,2), Xuezheng Sun (1), Chiu-Kit Tse (1), Andrew F. Olshan (1,2), Melissa A. Troester (1,2), Kathleen Conway (1,2) Keywords:... Full description

Journal Title: Cancer Causes & Control 2017, Vol.28(9), pp.929-938
Main Author: Parada, Humberto
Other Authors: Sun, Xuezheng , Tse, Chiu-Kit , Olshan, Andrew , Troester, Melissa , Conway, Kathleen
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0957-5243 ; E-ISSN: 1573-7225 ; DOI: 10.1007/s10552-017-0923-x
Link: http://dx.doi.org/10.1007/s10552-017-0923-x
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recordid: springer_jour10.1007/s10552-017-0923-x
title: Active smoking and survival following breast cancer among African American and non-African American women in the Carolina Breast Cancer Study
format: Article
creator:
  • Parada, Humberto
  • Sun, Xuezheng
  • Tse, Chiu-Kit
  • Olshan, Andrew
  • Troester, Melissa
  • Conway, Kathleen
subjects:
  • Smoking
  • Breast cancer
  • Survival analysis
  • Mortality
ispartof: Cancer Causes & Control, 2017, Vol.28(9), pp.929-938
description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s10552-017-0923-x Byline: Humberto Parada (1,2), Xuezheng Sun (1), Chiu-Kit Tse (1), Andrew F. Olshan (1,2), Melissa A. Troester (1,2), Kathleen Conway (1,2) Keywords: Smoking; Breast cancer; Survival analysis; Mortality Abstract: Purpose To examine racial differences in smoking rates at the time of breast cancer diagnosis and subsequent survival among African American and non-African American women in the Carolina Breast Cancer Study (Phases I/II), a large population-based North Carolina study. Methods We interviewed 788 African American and 1,020 Caucasian/non-African American women diagnosed with invasive breast cancer from 1993 to 2000, to assess smoking history. After a median follow-up of 13.56 years, we identified 717 deaths using the National Death Index 427 were breast cancer-related. We used Cox regression to examine associations between self-reported measures of smoking and breast cancer-specific survival within 5 years and up to 18 years after diagnosis conditional on 5-year survival. We examined race and estrogen receptor status as potential modifiers. Results Current (vs never) smoking was not associated with 5-year survival however, risk of 13 year conditional breast cancer-specific mortality was elevated among women who were current smokers at diagnosis (HR 1.54, 95% CI 1.06--2.25), compared to never smokers. Although smoking rates were similar among African American (22.0%) and non-African American (22.1%) women, risk of breast cancer-specific mortality was elevated among African American (HR 1.69, 95% CI 1.00--2.85), but only weakly elevated among non-African American (HR 1.22, 95% CI 0.70--2.14) current (vs. never) smokers (P .sub.Interaction = 0.30). Risk of breast cancer-specific mortality was also elevated among current (vs never) smokers diagnosed with ER.sup.- (HR 2.58, 95% CI 1.35--4.93), but not ER.sup.+ (HR 1.11, 95% CI 0.69--1.78) tumors (P .sub.Interaction = 0.17). Conclusions Smoking may negatively impact long-term survival following breast cancer. Racial differences in long-term survival, as related to smoking, may be driven by ER status, rather than by differences in smoking patterns. Author Affiliation: (1) Department of Epidemiology, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB 7435, Chapel Hill, NC, 27599, USA (2) Lineberger Comprehensive Cancer Center, University
language: eng
source:
identifier: ISSN: 0957-5243 ; E-ISSN: 1573-7225 ; DOI: 10.1007/s10552-017-0923-x
fulltext: fulltext
issn:
  • 1573-7225
  • 15737225
  • 0957-5243
  • 09575243
url: Link


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titleActive smoking and survival following breast cancer among African American and non-African American women in the Carolina Breast Cancer Study
creatorParada, Humberto ; Sun, Xuezheng ; Tse, Chiu-Kit ; Olshan, Andrew ; Troester, Melissa ; Conway, Kathleen
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descriptionTo access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s10552-017-0923-x Byline: Humberto Parada (1,2), Xuezheng Sun (1), Chiu-Kit Tse (1), Andrew F. Olshan (1,2), Melissa A. Troester (1,2), Kathleen Conway (1,2) Keywords: Smoking; Breast cancer; Survival analysis; Mortality Abstract: Purpose To examine racial differences in smoking rates at the time of breast cancer diagnosis and subsequent survival among African American and non-African American women in the Carolina Breast Cancer Study (Phases I/II), a large population-based North Carolina study. Methods We interviewed 788 African American and 1,020 Caucasian/non-African American women diagnosed with invasive breast cancer from 1993 to 2000, to assess smoking history. After a median follow-up of 13.56 years, we identified 717 deaths using the National Death Index 427 were breast cancer-related. We used Cox regression to examine associations between self-reported measures of smoking and breast cancer-specific survival within 5 years and up to 18 years after diagnosis conditional on 5-year survival. We examined race and estrogen receptor status as potential modifiers. Results Current (vs never) smoking was not associated with 5-year survival however, risk of 13 year conditional breast cancer-specific mortality was elevated among women who were current smokers at diagnosis (HR 1.54, 95% CI 1.06--2.25), compared to never smokers. Although smoking rates were similar among African American (22.0%) and non-African American (22.1%) women, risk of breast cancer-specific mortality was elevated among African American (HR 1.69, 95% CI 1.00--2.85), but only weakly elevated among non-African American (HR 1.22, 95% CI 0.70--2.14) current (vs. never) smokers (P .sub.Interaction = 0.30). Risk of breast cancer-specific mortality was also elevated among current (vs never) smokers diagnosed with ER.sup.- (HR 2.58, 95% CI 1.35--4.93), but not ER.sup.+ (HR 1.11, 95% CI 0.69--1.78) tumors (P .sub.Interaction = 0.17). Conclusions Smoking may negatively impact long-term survival following breast cancer. Racial differences in long-term survival, as related to smoking, may be driven by ER status, rather than by differences in smoking patterns. Author Affiliation: (1) Department of Epidemiology, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB 7435, Chapel Hill, NC, 27599, USA (2) Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Article History: Registration Date: 04/07/2017 Received Date: 31/03/2017 Accepted Date: 04/07/2017 Online Date: 10/07/2017 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s10552-017-0923-x) contains supplementary material, which is available to authorized users.
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