Smoking cessation in long-term survivors of germ cell tumor (GCT)

Abstract

4737 Background: Cigarette smoking is the most significant source of preventable morbidity and premature mortality in developed countries. As long-term survivors of GCT have been found to be at an increased risk of developing vascular events and second cancer, smoking cessation could be an important factor to improve health status and overall survival. The purpose of this study was to investigate the use of tobacco in patients after GCT therapy. Methods: 474 patients treated for GCT between 1979 and 2000 at the University of Munich were asked to complete a self-report questionnaire on psychosocial dimensions which included items on tobacco smoking before and after treatment of GCT. These data were compared with those on smoking habits in the general male population in Germany. Results: 341 of 474 patients (71.9%) returned a completed questionnaire. The median age of responding patients was 41.9 years at the time of the study and 31.2 years at the time of GCT diagnosis. The median follow-up period was 9.6 years. 114 of 341 patients (33.4%) reported to smoke at the time of the study. 108 were cigarette smokers with 67.7% smoking more than 10 cigarettes a day. With respect to different groups of age (< 20 years, 20 - 29 years, 30 - 39 years and 40 - 49 years), 33.3%, 37.7%, 36.1% and 18.2% reported to smoke. The corresponding percentages of smoking patients in the general male population are 27.9%, 43.3%, 45.5%, and 42.7%. After diagnosis and/or therapy of GCT 83.8% of smoking patients had changed their smoking behavior by either having reduced (20%), having temporarily stopped (28.1%) or having definitively stopped smoking (35.7%). Patients reduced or stopped smoking irrespective of tumor histology (seminoma vs nonseminoma; p=0.33), tumor stage (I vs. II vs III; p=0.47), whether they had received chemotherapy or not (p=0.89), and irrespective of the number of chemotherapy courses applied (p=0.88). With advancing age more patients tended to stop smoking. Conclusions: After diagnosis and treatment of GCT most patients changed their habit of tobacco smoking. This resulted in lower numbers of smoking patients as compared to the general male population in Germany. No significant financial relationships to disclose.