title: Cigarette smoking and pulmonary function in adult survivors of childhood cancer exposed to pulmonary-toxic therapy: results from the St. Jude lifetime cohort study.
abstract: Treatments for childhood cancer can impair pulmonary function. We assessed the potential impact of cigarette smoking on pulmonary function in 433 adult childhood cancer survivors (CCS) who received pulmonary-toxic therapy, using single breath diffusion capacity for carbon monoxide corrected for hemoglobin (DLCOcorr), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC). FEV1/FVC median values among current [1.00; interquartile range (IQR): 0.94-1.04] and former smokers (0.98; IQR: 0.93-1.04) were lower than those who had never smoked (1.02; IQR: 0.96-1.06; P = 0.003). Median FEV1/FVC values were lower among those who smoked ≥ 6 pack-years (0.99; IQR: 0.92-1.03) and those who smoked <6 pack-years (1.00; IQR: 0.94-1.04), than among those who had never smoked (P = 0.005). Our findings suggest that CCSs have an increased risk for future obstructive and restrictive lung disease. Follow-up is needed to determine whether smoking imparts more than additive risk. Smoking prevention and cessation need to be a priority in this population.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: S Cristina
authors.initials: SC
authors.lastname: Oancea
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Rohit P
authors.initials: RP
authors.lastname: Ojha
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Vida L
authors.initials: VL
authors.lastname: Tyc
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: DeoKumar
authors.initials: D
authors.lastname: Srivastava
authors.affiliation: Department of General Pediatrics, St. Jude Children's Research Hospital, Memphis, Tennessee. Department of Pediatric Pulmonology, University of Tennessee, Memphis, Tennessee.
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Stokes
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee. Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee. daniel.green@stjude.org.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009369:Neoplasms / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology*; D017741:Survivors