Effect of smoking on survival following Non-Hodgkin Lymphoma in Ireland

Abstract

Abstract Background Although Ireland has been to the fore in tobacco control, smoking rates are falling slowly. There is a growing body of evidence that smoking cessation improves outcomes following the diagnosis of several cancers. Notwithstanding the adverse outcomes, a significant number of people who have been diagnosed with cancer continue to smoke. The aim of this study was to determine the role of smoking in overall and 5-year survival in patients diagnosed with Non-Hodgkin Lymphoma (NHL) between 1996 to 2016 (inclusive) in Ireland. Methods Data relating to 12,693 patients diagnosed with NHL was obtained from the National Cancer Registry of Ireland. Kaplan Meier survival analysis with log-rank test was conducted to determine the overall and 5-year survival. Multivariate Cox regression adjusted for age and gender was performed. Results Tobacco smoking has a significant influence on survival following NHL (p = 0.001). Young patients and non-smokers had superior 5-year survival at 87.5% and 59% respectively. On univariate analysis, current and ex-smoking were each significantly associated with increased mortality. After adjustment for age and gender, current smoking remained significant with increased mortality risk (HR-1.47, 95% CI = 1.23-1.76). Conclusions Smoking status is significantly associated with survival from NHL. Smoking cessation in cancer patients is a key component in the improvement of survival. Targeted smoking cessation services for cancer patients are needed; research on the best approach is currently being conducted by this research group. Key messages Current smoking impairs survival from Non-Hodgkin lymphoma. Targeted smoking cessation services for cancer patients are required.