Smoking and quality of life among female survivors of breast, colorectal and endometrial cancers in a prospective cohort study.
OBJECTIVE
To examine the association of smoking and quality of life (QOL) among survivors of breast, colorectal, or endometrial cancers.


METHODS
The study included women who joined the Iowa Women's Health Study in 1986 and were subsequently diagnosed with breast, colorectal, or endometrial cancers through 2004 (n = 1920). Smoking status was reported at baseline and in 2004; QOL was assessed in 2004 using the Medical Outcomes Study Short Form-36. Multivariate-adjusted odds ratios were calculated to examine the associations of smoking status and poor QOL (score lower than one-half a standard deviation below the mean of the non-smokers).


RESULTS
Compared with non-smokers, persistent smokers had higher likelihood of reporting poor Physical Functioning (odds ratio [OR] = 2.40, 95% confidence interval [CI] = 1.32-4.37), Mental Health (OR = 1.92, CI = 1.09-3.40), and Role Emotional (OR = 2.01, CI = 1.10-3.66), whereas former smokers had higher likelihood of reporting poor Physical Functioning (OR = 1.65, CI = 1.10-2.45), Mental Health (OR = 1.62, CI = 1.11-2.37), and General Health (OR = 1.51, CI = 1.03-2.21). A statistically significant trend toward higher likelihood of poor QOL was observed across smoking groups in Vitality, Physical Functioning, Mental Health, and Role Emotional. Further adjustment for physical activity resulted in attenuation of the odds ratios and p-values for trend.


CONCLUSIONS
Among women with breast, colorectal, or endometrial cancers, smokers were more likely than former or non-smokers to have poor QOL. Physical activity explained, in part, the association between smoking status and QOL in our study.
Jang
Sekwon
S
Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, 55455, USA. jangx079@umn.edu
Prizment
Anna
A
Haddad
Tufia
T
Robien
Kim
K
Lazovich
Deann
D
D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000523:psychology*; D016889:Endometrial Neoplasms / Q000401:mortality / Q000523:psychology*; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012907:Smoking / Q000523:psychology*; D017741:Survivors
J Psychosom Res. 1992 Jan;36(1):55-65
1538350
Cancer Epidemiol Biomarkers Prev. 2003 Nov;12(11 Pt 1):1121-9
14652270
Med Sci Sports. 1974 Summer;6(2):122-5
4461970
J Public Health Med. 1997 Sep;19(3):268-73
9347449
J Clin Oncol. 1999 Jan;17(1):352-60
10458254
Arch Intern Med. 2008 Oct 13;168(18):1968-74
18852397
Med Care. 1992 Jun;30(6):473-83
1593914
JAMA. 1993 Jan 27;269(4):483-7
8419667
Arch Gen Psychiatry. 1996 Nov;53(11):1043-7
8911227
Am J Epidemiol. 1988 Oct;128(4):740-8
3421240
Med Care. 2003 May;41(5):582-92
12719681
Am J Health Behav. 2008 Jan-Feb;32(1):93-110
18021037
Prev Med. 1999 Sep;29(3):139-44
10479599
Am J Prev Med. 2005 Feb;28(2):182-7
15710274
Am J Health Promot. 2006 Mar-Apr;20(4):251-8
16555798
N Engl J Med. 1996 Sep 26;335(13):931-7
8782500
Health Qual Life Outcomes. 2009 Feb 06;7:10
19200385
Am J Prev Med. 2007 Dec;33(6 Suppl):S318-26
18021906
Gen Hosp Psychiatry. 2002 May-Jun;24(3):140-7
12062138
N Engl J Med. 2008 Mar 20;358(12):1250-61
18354103
Spine (Phila Pa 1976). 2000 Dec 15;25(24):3130-9
11124729
J Clin Oncol. 2008 May 1;26(13):2198-204
18445845
Oral Oncol. 2007 Feb;43(2):187-92
16860590
Cancer. 2006 Jan 1;106(1):17-27
16311986
J Clin Oncol. 2005 Aug 20;23(24):5814-30
16043830
Chest. 2004 Dec;126(6):1733-41
15596667
Cancer Control. 2003 Jul-Aug;10(4):325-33
12915811