Shepherd, L;
Ryom, L;
Law, M;
Petoumenos, K;
Hatleberg, CI;
d'Arminio Monforte, A;
Sabin, C;
... D:A:D Study group; + view all
(2019)
Cessation of Cigarette Smoking and the Impact on Cancer Incidence in HIV-positive Persons: The D:A:D Study.
Clinical Infectious Diseases
, 68
(4)
pp. 650-657.
10.1093/cid/ciy508.
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Abstract
Background: Cancers are a major source of morbidity and mortality for HIV-positive persons on combination antiretroviral therapy, while the clinical benefits of smoking cessation are not well established. Methods: Participants were followed from 1 January 2004 until first cancer diagnosis, death, or 1 February 2016. Smoking status was defined as ex (<1,1-2,2-3,3-5,>5 years since stopping), current, and never smokers. Outcomes considered were any cancer, lung cancer, other smoking-related excluding lung and smoking-unrelated cancers. Adjusted incidence rate ratios (aIRR) were calculated using Poisson regression, adjusting for demographic and clinical factors. Results: 35442 persons from the D:A:D study contributed 309803 person years of follow-up. At baseline, 49% of people were current smokers, 21% were ex-smokers, 30% had never smoked. Incidence of all cancers combined (N=2183) was highest <1 year after smoking cessation compared to never smokers (aIRR: 1.66 95%CI: 1.37, 2.02) and not significantly different from never smokers 1-2 years after cessation. Lung cancer incidence (N=271) was elevated <1 year after cessation (aIRR: 19.08 95%CI: 8.10, 44.95) and remained 8-fold higher 5 years after smoking cessation (aIRR: 8.69 95%CI: 3.40, 22.18). Incidence of other smoking-related cancers (N=622) excluding lung was elevated in the first year after cessation (aIRR: 2.06 95%CI: 1.42, 2.99) and declined to a level similar to non-smokers thereafter. Incidence of smoking-unrelated cancers (N=1290) was unrelated to smoking status. Conclusion: Lung cancer incidence remained elevated for more than 5 years after smoking cessation. Deterring uptake of smoking and smoking cessation efforts should be a priority to reduce the future risk of cancer.
| Type: | Article |
|---|---|
| Title: | Cessation of Cigarette Smoking and the Impact on Cancer Incidence in HIV-positive Persons: The D:A:D Study |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/cid/ciy508 |
| Publisher version: | https://doi.org/10.1093/cid/ciy508 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | HIV, smoking, smoking cessation, cancer |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10051293 |
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