882P - Quitting smoking after diagnosis of head and neck cancer is associated with reduced risk of mortality: A multicentric prospective cohort study

Background

While strong evidence indicates quitting smoking reduces the risk of developing head and neck cancer (HNC), it remains unclear whether patients who smoke could still benefit from quitting after HNC diagnosis. We investigated the impact of postdiagnosis smoking cessation on the survival of patients with HNC who smoked at diagnosis.

Methods

This prospective study included 1,298 participants who were diagnosed with HNC in the United Kingdom (Head and Neck 5000 study, recruitment: 2011-2014), and 4 countries in Latin America (Brazil, Argentina, Uruguay, and Colombia - INTERCHANGE study, recruitment: 2011-2017) who actively smoked at diagnosis. Participants have been actively followed since their diagnosis to collect regular information on their smoking behavior and disease status. Overall survival was evaluated using extended Kaplan-Meier curves and time-dependent Cox proportional hazards regression models.

Results

During the follow-up, 442 participants (34%) reported quitting smoking, and 571 deaths were recorded. Median survival time was 17 months higher when patients quit vs. continued smoking (median survival time = 6.6 vs. 5.2 years, p<0.001). At 5-years, the survival rate was significantly higher when patients quit vs. continued smoking (61.0% vs. 50.6%, p<0.001). After accounting for the quitting time and adjusting for potential confounders, quitting smoking was associated with 33% lower risk of death compared to continued smoking (HR=0.67, 95%CI=0.56-0.81). Stratified analyses revealed consistent survival benefits associated with quitting smoking among all patient subgroups, including those who reported mild-moderate vs. heavy smoking, and patients who were diagnosed with earlier vs. later-stage tumors. The benefits of quitting smoking were also evident across various HNC subtypes.

Conclusions

Quitting smoking after HNC diagnosis may significantly reduce the risk of death and improve survival among patients who smoke. These findings underscore the importance of post-diagnosis smoking cessation interventions as part of comprehensive cancer care for HNC patients.

Clinical trial identification

Editorial acknowledgement

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.