| Title: | Smoking and the Risk of Second Primary Lung Cancer Among Breast Cancer Survivors from the Population-Based UK Biobank Study |
| Journal: | Clinical Lung Cancer |
| Published: | 1 Sep 2024 |
| DOI: | https://doi.org/10.1016/j.cllc.2024.08.017 |
Publication 13137
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
Objective : Long-term breast cancer (BC) survivors are known to develop second malignancies, with second primary lung cancer (SPLC) one common type. Smoking was identified as a main risk factor for SPLC among BC survivors. These findings were limited to the U.S. and focused on smoking status, not incorporating cumulative smoking exposures (e.g., pack-years). We examine SPLC incidence and evaluate the associations between SPLC risk and cumulative cigarette smoking exposures and other potential factors among BC survivors in a prospective European cohort. Methods : Of 502,505 participants enrolled in the UK Biobank in 2006-2010, we identified 8,429 patients diagnosed with BC between 2006-2016 and followed for second malignancies through 2016. Smoking information was collected at enrollment, and treatment data were collected using electronic health records. Multivariable cause-specific Cox regression (CSC) evaluated the association between each factor and SPLC risk. Results : Of 8,429 BC patients, 40 (0.47%) developed SPLC over 45,376 person-years. The 10-year cumulative SPLC incidence was 0.48% (95% CI=0.33-0.62%). The CSC analysis confirmed the association between SPLC and ever-smoking status (adjusted hazard-ratio (aHR)=3.46 (p<.001). The analysis showed a 24% increment in SPLC risk per 10 smoking pack-years among BC survivors (aHR=1.24 per-10 pack-years, p=0.01). The associations between SPLC and other variables remained statistically insignificant. We applied the USPSTF lung cancer screening eligibility criteria and found that 80% of the 40 BC survivors who developed SPLC would have been ineligible for lung cancer screening. Conclusion : In a large, European cohort, cumulative smoking exposure is significantly associated with SPLC risk among BC survivors. Micro-Abstract In a large population-based cohort in the U.K., the risk of second primary lung cancer (SPLC) among breast cancer survivors is associated with an ever-smoking history as well as cumulative smoking pack years. This finding has important public-health implications because smoking is a modifiable risk factor and underscores the need for tailored prevention strategies for SPLC in breast cancer survivors.</p>
8 Authors
- Anna Graber-Naidich
- Eunji Choi
- Julie T. Wu
- Timothy J. Ellis-Caleo
- Joel Neal
- Heather A. Wakelee
- Allison W. Kurian
- Summer S. Han
Enabling scientific discoveries that improve human health