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Cigarette smoking is associated with adverse survival among women with ovarian cancer: results from a pooled analysis of 19 studies

Praestegaard, C; Jensen, A; Jensen, SM; Nielsen, TS; Webb, PM; Nagle, CM; DeFazio, A; ... Ovarian Cancer Association Consortium, .; + view all (2017) Cigarette smoking is associated with adverse survival among women with ovarian cancer: results from a pooled analysis of 19 studies. International Journal of Cancer , 140 (11) pp. 2422-2435. 10.1002/ijc.30600. Green open access

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Abstract

Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumours but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08-1.28) and former smokers (pHR = 1.10, 95% CI: 1.02-1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01-3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00-1.23; former smoking: pHR = 1.12, 95% CI: 1.04-1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localised than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis. This article is protected by copyright. All rights reserved.

Type: Article
Title: Cigarette smoking is associated with adverse survival among women with ovarian cancer: results from a pooled analysis of 19 studies
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ijc.30600
Publisher version: http://doi.org/10.1002/ijc.30600
Language: English
Additional information: © 2017 UICC. This is the peer reviewed version of the following article: Praestegaard, C; Jensen, A; Jensen, SM; Nielsen, TS; Webb, PM; Nagle, CM; DeFazio, A; (2017) Cigarette smoking is associated with adverse survival among women with ovarian cancer: results from a pooled analysis of 19 studies. International Journal of Cancer 10.1002/ijc.30600, which has been published in final form at http://doi.org/10.1002/ijc.30600. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Cigarette smoking, ovarian cancer, pooled analysis, survival
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 > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/1536066
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