Presentation Authors: Brian Winters*, Sarah Holt, Atreya Dash, John Gore, George Schade, Jonathan Wright, Seattle, WA
Introduction: Smoking is the most common risk factor for urothelial carcinoma (UC) and is associated with worsened surgical outcomes. At the time of diagnosis, patients are often counseled regarding smoking cessation, however, there is limited data suggesting this is effective. The diagnosis of UC may represent a &[Prime]teachable moment&[Prime] for smoking cessation. We examined smoking cessation trends using the Medicare Health Outcomes Survey (MHOS).
Methods: We evaluated SEER-MHOS (1998-2013) for all patients with incident UC and survey data available within two years pre- or post-diagnosis. We compared these patients 1:5 to propensity matched non-cancer controls (smoking status included) as well as a second cohort of incident renal cell carcinoma (RCC) patients. Differences in smoking trends and/or cessation were compared between groups. Logistic regression, adjusted for age and education, was used to illustrate the likelihood of smoking cessation.
Results: 394 newly diagnosed bladder cancer patients were propensity matched to 1,970 non-cancer controls and compared with 169 RCC patients. Smoking prevalence was more common in UC (17%, 68/394) compared with RCC patients (12%, 20/169). Smoking cessation was more common among smokers diagnosed with UC than in non-cancer controls (27% vs 21% stopped smoking, respectively) but similar to RCC patients (26%). Adjusted odds ratios revealed non-significant trends towards quitting smoking in UC and RCC compared with controls (1.3, 95%CI: 0.7-2.5; 1.2, 95%CI: 0.4-3.6). There were no differences in smoking cessation between UC and RCC (p=0.92) or when stratifying the newly diagnosed by stage (p=0.86).
Conclusions: Patients with newly diagnosed UC or RCC quit smoking at higher rates that matched non-cancer controls, however the majority of patients reported continued smoking. Given these relatively low rates of smoking cessation after cancer diagnoses related to tobacco use, improved efforts are needed to utilize this &[Prime]teachable moment&[Prime] to experience the cancer-specific and overall health benefits of smoking cessation.
Source of Funding: Howard J Cohen Bladder Cancer Foundation