1586 Background: Tobacco is the leading cause of preventable death in the US and is linked to many cancers most notably lung cancer. It is established that smoking not only causes lung cancer but is also associated with decreased survival. Obesity is an emerging leading cause of morbidity and mortality in the US and the relationship between obesity, tobacco, and survival in NSCLC is unclear. Methods: Data (n= 87,631) were obtained from linkage of the 1996-2007 Florida Cancer Data System, a population-based cancer registry, to the Agency for Health Care Administration database providing procedure and diagnoses codes. Survival time was calculated from date of diagnosis to date of death. Smoking status was categorized as never, current, and former. Obesity (yes/no) was determined by body mass index greater than 30. Cox proportional regression models were used to predict survival; demographic, clinical, treatment factors, and comorbidities were included in adjusted models with smoking status and obesity as the main factors. Results: The majority of patients were either former (49%) or current (40%) smokers, and non-obese (93%). There were significant differences between survival curves and median survival (months) for obese vs. non-obese patients (19.9 vs.9.8; P<.001). Former and current smokers had shorter median survival than never smokers (10.8 & 9.2 vs. 11.9; P<.001). Survival rates (%) at 1-yr (60.0 vs. 44.8; P<.001), 3-yr (38.4 vs. 22.1; P<.001) and 5-yr (30.2 vs. 15.0; P<.001) were better for obese vs. non-obese patients. Independent predictor of worse survival in the unadjusted model was former (HR 1.08; P<.001) and current (HR 1.20; P<.001) smokers compared to never. Obese patients had better survival vs. non-obese patients (HR 0.64; P<.001). In the adjusted model, controlling for extensive variables and comorbidities, former (HR 1.14; P<.001) and current (HR 1.22; P<.001) smokers still had significantly worse survival vs. never smokers. Obese patients still had better survival (HR 0.84; P<.001) vs. non-obese patients. Conclusions: Our results show that being a former or current smoker worsens survival while obesity improved survival regardless of smoking status when compared with non obese patients.
GSTM1, GSTT1 and GSTP1 polymorphisms, environmental tobacco smoke exposure and risk of lung cancer among never smokers: a population-based study