Chest
Clinical InvestigationsSMOKINGSmoking and Lung Cancer Survival: The Role of Comorbidity and Treatment
Section snippets
Materials and Methods
A historical cohort study was carried out in the Henry Ford Health System to evaluate the impact of comorbidity, smoking, and other factors on the survival of patients with lung cancer. Study subjects, identified through the Josephine Ford Cancer Center Tumor Registry, had primary bronchogenic lung cancer diagnosed between January 1, 1995, and December 31, 1998, and received their principal care at the Henry Ford Health System. The study was limited to black and white patients because all other
Results
The sample consisted of 470 women (41%), 685 men (59%), 462 blacks (40%), and 693 whites (60%). The distribution of selected sociodemographic, smoking, clinicopathologic, and treatment variables, stratified by gender and race/ethnicity, are presented in Table 1. The mean age of subjects was 67.2 years, and age did not differ significantly by gender and race/ethnicity. SES was considerably lower in blacks than in whites (BGMHI, $19,903 vs $38,812; p = 0.0001). Being without a spouse was
Discussion
Current smoking at diagnosis increased the hazard of dying by approximately one third compared to former/never smokers, and this effect was observed in different age, gender, race/ethnic, histologic, and stage groups. Patients with lung cancer who were current smokers at diagnosis were more likely to have numerous negative prognostic factors. However, adjusted for important sociodemographic, exposure, clinicopathologic, comorbidity, and treatment factors, current smoking remained a significant
ACKNOWLEDGMENT
We thank Drs. Joseph L. Lewis and Mei Lu for their reviews of the manuscript, and medical students Ginja B. Massey and Mandira Ray for assistance in abstracting data.
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This study was internally funded by the Henry Ford Health System.