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Continuing Smoking and Drinking Increases Risk of Death Among Survivors of Head and Neck Cancer


New Haven, Conn. — Continuing to regularly smoke or drink alcohol after a diagnosis of head and neck cancer increases a patient’s chance of dying, a Yale-led team of researchers has found. The study appears in the December issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Nearly 50,000 Americans are diagnosed with oral, pharynx and larynx cancers each year. It was already known that cigarette smoking and alcohol consumption before diagnosis increased the risk of these individuals developing second head and neck cancers, but until now it was unclear what role continuing these habits played in overall cancer survivorship.

The Yale-led team followed 264 survivors of early stage head and neck cancer for up to seven years. Patients were recruited from 49 hospitals in Connecticut and Florida. Twenty-one percent of patients smoked continuously after diagnosis. Those who did were approximately twice as likely to die as those who did not smoke, and those who continued to drink regularly were around three times as likely to die as those who did not.

According to senior author Susan Mayne, associate director of the Yale Cancer Center and professor of epidemiology at the Yale School of Medicine and School of Public Health, “We expected that continued smoking would be associated with poorer overall survival. We did not know what to expect for continued drinking, because moderate alcohol consumption has been associated with a lower risk of cardiovascular disease in the general population. Our results showed that continued drinking was harmful, even more so than continued smoking - an unexpected finding.”

Based on this result, Mayne said that accelerating efforts to help patients stop smoking and drinking could result in better survival rates. “Effective smoking and alcohol interventions will not only prevent second cancers, but will also reduce the risk of dying,” Mayne said.

Other authors include Brenda Cartmel of Yale University, Victoria Kirsh of Yale and Cancer Care Ontario, Toronto, Ontario, and W. Jarrard Goodwin, Jr. of the University of Miami and Sylvester Comprehensive Cancer Center, Miami.

This research was supported by the National Cancer Institute.


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