Active and Passive Cigarette Smoking and Mortality among Hispanic and non-Hispanic White Women Diagnosed with Invasive Breast Cancer
A partir des données de la cohorte américaine "the Breast Cancer Health Disparities Study" incluant 1 020 participantes hispaniques et 1 198 participantes blanches, cette étude évalue l'association entre une exposition au tabagisme actif et passif et la mortalité, chez des patientes atteintes d'un cancer du sein invasif (durée médiane de suivi : 10, 6 ans)
Purpose : Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than non-smokers; however, differences by ethnicity or prognostic factors and risk for non-cancer mortality have not been evaluated. Methods : We examined associations of active and passive smoke exposure with mortality among Hispanic (n=1,020) and non-Hispanic White (n=1,198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years). Results : Risk of breast cancer-specific (HR=1.55, 95% CI:1.11-2.16) and all-cause (HR=1.68, 95% CI:1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of non-cancer mortality (HR=1.68, 95% CI:1.12-2.51). Associations were strongest for current smokers who smoked ≥20 years, were postmenopausal, overweight/obese, or reported moderate/high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased 2-fold for moderate/high recent passive smoke exposure among never smokers (HR=2.12, 95% CI:1.24-3.63). Conclusions : Findings support associations of active and passive smoking diagnosis with risk of breast cancer-specific and all-cause mortality, and ever smoking with non-cancer mortality, regardless of ethnicity and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation and maintenance programs should be routinely recommended for women with breast cancer.