Twenty percent of British adult survivors of childhood cancers are current smokers, and nearly a third have been regular smokers at some point in their lives, according to a study in the July 29 online issue of the Journal of the National Cancer Institute.
Adult survivors of childhood cancer are at increased risk of developing cardiovascular disease, lung problems, and second malignancies, relative to the general public. These increased risks are due to long-term effects of the original cancer and its treatment, as well as to genetic conditions that predispose the survivors to multiple cancers. Smoking would be an additional source of risk for this population.
To learn what fraction of adult survivors are current smokers or have smoked regularly in the past, Clare Frobisher, Ph.D., of the University of Birmingham, UK, and colleagues sent surveys to all those who could be contacted from among 14,836 eligible survivors of childhood cancer in the National Registry of Childhood Tumors. To be eligible for the study, survivors had to have been diagnosed with their primary cancer between 1940 and 1991 and be aged 16 years or older at the time of the survey. Of those survivors, 10,326 returned completed study questionnaires and were included in the current analysis.
Of the respondents, 20 percent were current regular smokers and 29.8 percent were regular smokers at some time in their life prior to the completion of the survey. When the researchers analyzed the responses by tumor site, they found that survivors of central nervous system cancers or heritable retinoblastoma were least likely to smoke, while survivors of Wilms tumor, Hodgkin lymphoma, or soft tissue sarcomas were most likely to report being a regular current smoker. Individuals who had been treated with radiation or chemotherapy were less likely to smoke than those who had not received that type of therapy. Also, those who did not have regular hospital follow-up appointments were more likely to smoke than those who did.
The rate of current smoking in the survivors was approximately half of the rate in the general British population. The socioeconomic factors that are associated with an increased risk of smoking in the general public, though, are the same as those in the adult survivor group, including manual occupations compared with managerial or professional work, lower educational attainment, and being widowed, divorced, or separated.
The relatively high rate of smoking in survivors of Wilms tumor, Hodgkin lymphoma, and soft tissue sarcomas is concerning because previous research suggests that these survivors are at a particularly high risk for second malignancies.