Effect of smoking on survival from non-small cell lung cancer: a retrospective Veterans’ Affairs Central Cancer Registry (VACCR) cohort analysis

Vijaya R Bhatt, Rishi Batra, Peter T. Silberstein, Fausto R. Loberiza, Apar Kishor P Ganti

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10 Scopus citations


Although a well-established risk factor for lung cancer, the impact of smoking on the survival of non-small cell lung cancer (NSCLC) is not well known. We performed a retrospective analysis of the Veteran’s Affairs Comprehensive Cancer Registry of NSCLC patients. Smoking status was categorized as never smoker, past smoker and current smoker based on self-reported history. Multivariate analysis was performed to evaluate the impact of smoking on overall survival (OS) from NSCLC. The study population (n = 61,440) comprised predominantly of males (98 %) and Caucasians (81 %). The median age at diagnosis was 68 years (range 22–108 years). Current smokers were diagnosed with NSCLC at a younger age (65 years) compared to never smokers (71 years) and past smokers (72 years) (p < 0.001). On multivariate analysis, current smokers (n = 34,613) [Hazard ratio (HR) 1.059; 95 % confidence interval (CI) 1.012–1.108], but not past smokers (n = 23,864) (HR 1.008; 95 % CI 0.962–1.056), had worse OS for Stage III and IV NSCLC, compared to never smokers (n = 2,963). Smoking status was not prognostic in stages I and II NSCLC. Current smokers were diagnosed with NSCLC at a younger age than never smokers. Although current smoking was associated with worse prognosis, especially in stages III and IV, the impact of smoking status on OS was modest.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalMedical Oncology
Issue number1
StatePublished - Jan 1 2015



  • Non-small cell lung cancer
  • Outcomes
  • Smoking
  • Survival
  • Tobacco

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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