Smoking is the most common risk factor for bladder cancer (BC) and is associated with adverse clinical outcomes. The diagnosis of BC represents a 'teachable moment' for smoking cessation. We investigate the likelihood of smoking cessation after BC diagnosis in a population database.
We evaluated SEER-MHOS (1998-2013) for all patients diagnosed with incident BC who had pre- and post-diagnosis survey data available. We compared these patients to propensity matched non-cancer controls (NCCs) and to a cohort of incident renal cell carcinoma (RCC) patients. Differences in smoking cessation were compared between groups and multivariate logistic regression performed to assess the likelihood of smoking cessation.
394 newly diagnosed bladder cancer patients were propensity matched to 1,970 NCCs and compared with 169 incident RCC patients. Baseline smoking prevalence was more common in patients diagnosed with BC (16%) compared with RCC (11%) (NS). The smoking cessation rates in BC patients was 27% compared with 21% in NCCs (p=0.30) and 26% in RCC patients (p=0.90). There were no significant differences in the adjusted odds ratios of quitting smoking in BC and RCC patients compared with NCCs (1.3, 95%CI: 0.7 - 2.5; 1.2, 95%CI: 0.5 - 3.6). Independent predictors of smoking cessation in BC patients included age (p=0.03), African American race (p=0.03), and college education (p=0.01).
Smoking cessation was not significantly different following the diagnosis of BC compared to propensity-matched NCCs. The proportion of individuals quitting was low overall, suggesting improved efforts are needed to utilize this teachable moment in BC patients.
The Journal of urology. 2019 Mar 05 [Epub ahead of print]
Brian R Winters, Lexiaochuan Wen, Sarah K Holt, Atreya Dash, John L Gore, George R Schade, Jonathan L Wright
Department of Urology, University of Washington School of Medicine , Seattle , WA., Drexel University College of Medicine , Philadelphia , PA.