Smoking remains the largest preventable cause of cancer (see summary of Surgeon General's Report). While smoking causes cancer at many organ sites, including lung, larynx, oral cavity and pharynx, esophagus, pancreas, bladder and kidney, cervix, stomach, and acute leukemia, the evidence review in 2004 by the Surgeon General indicated that the evidence was suggestive of a casual relation for colorectal cancer and for liver cancer. For prostate cancer the data as of 2004 indicated no causal relation of smoking to risk or onset of prostate cancer but suggested a higher mortality from prostate cancer in smokers. The new report in JAMA by Kenfield and colleagues adds important prospective data on mortality among men who have prostate cancer.
Following some 5366 men diagnosed with prostate cancer, they report excess deaths among men who were current cigarette smokers at the time of diagnosis when these men are compared to never smokers. Excess deaths due to prostate cancer were observed, as were excess deaths from all causes and from cardiovascular disease. Current smokers had an excess mortality from prostate cancer compared to never smokers (relative risk of death 1.6, equivalent to 6 extra deaths per 1000 men per year).
Importantly men who had quit smoking 10 or more years before diagnosis had lower mortality than current smokers and were similar to those who had never smoked.
Men who are current smokers at the time of diagnosis of their prostate cancer have excess total mortality, death from cardiovascular disease, and death from prostate cancer. This study adds yet another good reason for men who smoke to quit, as prostate cancer is the most commonly diagnosed cancer in men.
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