Cancer Screening and Diagnosis: Opportunities for Smoking Cessation Intervention

Menée sur 12 182 puis 12 538 fumeurs, cette étude évalue les taux d'arrêt du tabagisme à 2 et 4 ans chez les fumeurs atteints d'un cancer récemment diagnostiqué et ceux n'ayant pas développé la maladie

Résumé en anglais

The article by Westmaas et al that accompanies this editorial demonstrated an increased rate of smoking cessation among Cancer Prevention Study II participants who were diagnosed with cancer as compared with those without cancer diagnoses. The authors concluded that cancer diagnosis provides a teachable moment for smoking cessation (teachable moment is described by McBride et al as “life transitions or health events thought to motivate individuals to spontaneously adopt risk-reducing health behaviors”. The clinical relevance of cessation at diagnosis is suggested by meta-analyses demonstrating that the relative risk of cancer-specific mortality among current smokers is 1.6 relative to never-smokers ; by comparison, the relative risk for former smokers is 1.03 relative to never-smokers. One may conclude that cessation at diagnosis will decrease the relative risk of an individual. However, the improvement in prognosis as a result of cessation at diagnosis is subject to variation as a result of longitudinal smoking status, lifetime exposure, and other important variables. Definitive population-level conclusions are difficult, in part because randomized trials of cessation among patients with newly diagnosed cancer are challenging to conduct, and many observational studies have not collected or adjusted for smoking status or other variables during follow-up. One reason that follow-up assessment is important is the finding by Westmaas et al of a 12% rate of smoking resumption among cancer patients who quit smoking at diagnosis. Thus, although Westmaas et al provide robust evidence that cessation is more likely after diagnosis, important research remains to be conducted regarding the impact on long-term outcomes of smoking and smoking cessation at the time of diagnosis. Data are sufficient, however, to conclude broadly that quitting smoking improves the prognosis of patients with cancer.