SAN DIEGO – While cigarette smoking is a risk factor for mortality in other genitourinary cancers, which appears to be linked to the accumulation of carcinogens in urine, the link has been less clear with prostate cancer, according to a new study.

Researchers from the VA San Diego Health Care System and the University of California San Diego sought to evaluate differences in prostate cancer-specific mortality among current smokers, past smokers, and never smokers diagnosed with PC.

The retrospective cohort study of PCSM in VA patients diagnosed with PC between 2000 and 2015 was published in the journal Prostate Cancer and Prostatic Diseases.1

Included in the cohort were 73,668 men with 30.7% current smokers, 32.1% past smokers and 37.1% never smokers.

Over median follow-up of 5.9 years, researchers reported that current smokers were younger at presentation (median age current: 63, never: 66; p < 0.001), and had more advanced disease stage (stage IV disease current: 5.3%, never: 4.3%; p < 0.04).

Results indicated that the 10-year incidence of PCSM was 5.2%, 4.8%, and 4.5% for current, past, and never smokers, respectively.

The study team determined that current smoking was associated with increased PC mortality (subdistribution hazard ratio: 1.14, 95% confidence interval: (1.05-1.24), p = 0.002), but past smoking was not, with tumor characteristics playing a role.

“Smoking at the time of diagnosis is associated with a higher risk of dying from PC as well as other causes of death,” the authors concluded. “In contrast, past smoking was not associated with PCSM suggesting that smoking may be a modifiable risk factor. PC diagnosis may be an important opportunity to discuss smoking cessation.”

  1. Riviere P, Kumar A, Luterstein E, Vitzthum LK, et. Al. Tobacco smoking and death from prostate cancer in US veterans. Prostate Cancer Prostatic Dis. 2019 Oct 17. doi: 1038/s41391-019-0178-6. [Epub ahead of print] PubMed PMID: 31624316.