Cancer risk among young men with weight gain after smoking cessation: A population-based cohort study |
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| Institution: | 1. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea;2. Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea;3. Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea;4. Big Data Steering Department, National Health Insurance Service, Wonju, Republic of Korea;1. Moffitt Cancer Center, Department of Health Outcomes and Behavior, 4115 E. Fowler Ave., Tampa, FL 33617, United States;2. Moffitt Cancer Center, Center for Immunization and Infection Research in Cancer, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;3. Moffitt Cancer Center, Department of Cancer Epidemiology, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;4. Moffitt Cancer Center, Department of Biostatistics and Bioinformatics, 12902 USF Magnolia Drive, Tampa, FL 33612, United States;5. University of South Florida, Department of Family Medicine, 13330 USF Laurel Drive, Tampa, FL 33612, United States;6. University of South Florida, Department of Epidemiology & Biostatistics, 13201 Bruce B Downs Blvd, Tampa, FL 33612, United States;8. University of Florida, Department of Medicine, 1600 SW Archer Rd., Gainesville, FL 32608, United States;9. University of Florida Health, Department of Health Outcomes and Biomedical Informatics, 2004 Mowry Road, Ste 2245, Gainesville, FL 32610, United States;10. University of Florida Health, Cancer Population Sciences, 2004 Mowry Road, Ste 2245, Gainesville, FL 32610, United States;1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States;2. Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences Durham, NC, United States;3. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States;4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States;5. Biospecimen Processing Center, University of North Carolina, Chapel Hill, NC, United States;6. Division of Oncology and Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, Philadelphia, PA, United States;7. Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA, United States;8. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States;9. Showers Center for Childhood Cancer and Blood Disorder, Akron Children’s Hospital, Akron, OH, United States;10. Department of Biostatistics, Colleges of Medicine and Public Health & Health Professions, University of Florida, Children’s Oncology Group Statistics & Data Center, Gainesville, FL, United States;11. Department of Otolaryngology, Washington University School of Medicine, St Louis, MO, 63110;1. Institute of Medical Epidemiology, Biostatistics and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Germany;2. Section of Cancer Information, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France;3. Department of Medicine, University of Zimbabwe School of Medicine, Harare, Zimbabwe;4. Department of Pathology, Maputo Central Hospital, Maputo, Mozambique;5. CTSU, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7FL, United Kingdom;6. African Cancer Registry Network, 267 Banbury Road, Oxford OX2 7HT, United Kingdom;1. Centre for Big Data Research in Health, University of New South Wales Sydney, NSW, Australia;2. Centre for Primary Health Care and Equity, University of New South Wales Sydney, NSW, Australia;3. School of Medicine, University of Wollongong, NSW, Australia;4. National Drug and Alcohol Research Centre, University of New South Wales Sydney, NSW, Australia;5. Faculty of Medicine and Health, University of Sydney, NSW, Australia;6. Cancer Voices NSW, NSW, Australia;1. Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA;2. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA;3. Genomics Research Center, Academia Sinica, Taipei, Taiwan;4. Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan;5. Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan;6. Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Sichuan, China;7. Department of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China;8. Department of Epidemiology and Biostatistics, Jiangsu key lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, China;9. Department of Epidemiology and Biostatistics, School of Public Health, Fujian Medical University, Fujian, China;10. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China;11. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China;12. Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China;13. Department of Epidemiology, School of Public Health, China Medical University, Liaoning, China;14. Department of Head & Neck Oncology, Henan Cancer Hospital, Henan, China;15. Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;p. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA;q. Department of Epidemiology and Center for Environmental Genomics, UCLA Fielding School of Public Health, Los Angeles, CA, USA;r. National Office of Cancer Prevention & Control Cancer Institute & Hospital, and Chinese Academy of Medical Sciences, Beijing, China;1. Faculty of Medicine and Health Sciences, Department of Social Epidemiology and Health Policy, University of Antwerp, Belgium;2. Department of Oncology, Antwerp University Hospital, Antwerp, Belgium;3. Centre for Cancer Detection, Bruges, Antwerp, Belgium;4. Molecular Imaging, Pathology, Radiotherapy & Oncology (MIPRO), University of Antwerp, Belgium |
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| Abstract: | BackgroundSmoking cessation may help the current smokers to reduce cancer risk. However, weight gain following smoking cessation may attenuate the protective association of cessation with cancer.Patients and methodsOur study included 1,278,794 men who were aged 20–39 years and underwent two consecutive health examinations by the National Health Insurance Service, without previous diagnosis of cancer. Participants were categorized into continual smokers, quitters with different degree of body weight change, and never smokers based on the biennial national health screening program (2002–2003 and 2004–2005) and were followed from January 1, 2006 to December 31, 2015. Cox proportional hazard models and restricted cubic spline model was used to evaluate the association of post-cessation weight change and cancer risk after adjustment for potential confounders.ResultsDuring the 10 years of follow-up, the analyses included 1,278,794 men with 21,494 cancer incidences. Compared to continual smokers, quitters without weight gain of 2.0 kg had significantly lower risk of obesity-related cancer (hazard ratio HR], 0.88; 95% confidence interval CI], 0.79-0.97), smoking-related cancer (HR, 0.90; 95% CI, 0.83 to 0.98), and gastrointestinal cancer (HR, 89; 95% CI, 0.80 to 0.98). Weight gain among quitters attenuated the risk reduction of cancer compared to continual smoking. Among quitters, weight gain up to 5.0 kg with smoking cessation showed protective association with cancer risk among quitters without weight gain.ConclusionExcessive weight gain with smoking cessation among quitters was not associated with reduced risk of several cancer types. This association should be taken into account when recommending smoking cessation to prevent cancer |
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| Keywords: | Smoking cessation Weight gain Men Neoplasms |
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