Presentation Authors: Bashir Al Hussein Al Awamlh*, Jonathan Shoag, Jonathan Fainberg, Omar Al Hussein AlAwamlh, Douglas Scherr, New York, NY
Introduction: Smoking has been linked to the development of prostate (Pca), bladder (Bca), and kidney cancer. Using detailed smoking histories, we aimed to explore the mortality associated with tobacco use in a contemporary, nationally representative sample of the United States civilian population.
Methods: Patients from the National Longitudinal Mortality Study that completed tobacco surveys (1993-2005) were followed for 5 years. Demographic, socioeconomic and smoking variables were available for analysis. Patients who died from Pca, Bca and kidney cancer were identified from death certificates. To quantify the effect of smoking; participants were sub-grouped based on the age they started smoking, current smoking status and whether they were second-hand smokers only. The association between smoking and mortality from urologic malignancies was assessed using multivariable Cox models adjusting for sociodemographic variables.
Results: We identified a total of 493,282 subjects, of whom 210,707 (42.7%) were smokers. Of those who died from Pca, Bca and kidney cancer; 65% (203 out of 313), 63% (72 out of 111) and 63% (84 out of 134) were smokers, respectively. The median age of participants who died of Pca was 76 years (IQR 68 to 82), Bca 77 years (IQR 71 to 81) and kidney cancer 70 years (IQR 60 to 77). Overall, of those who died from urologic malignancies; 37.1% were former smokers, 38.4% started smoking when they were teenagers and 5% were second-hand smokers only. _x000D_
Median follow up for alive patients was 60 months. Smoking was independently associated with death from urologic malignancies in multivariable Cox models (Table). Smoking at earlier age and former smokers were more likely to die of Bca and kidney cancer than non-smokers. Second-hand smoking was associated with death from Bca and Pca, but not kidney cancer.
Conclusions: In a nationally representative study, we confirmed the association between smoking intensity and mortality from urologic malignancies. In addition, we found that second-hand smokers appeared to suffer many of the deleterious effects of smoking. This data confirms the necessity of smoking cessation counseling for urologists.