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 Researchers studied 463 patients with head and neck squamous cell
carcinoma, a common type of cancer that develops in the outer layer
of the skin. It is often slow growing and treatable with medication
or minor surgery, but some types can be aggressive and deadly.
Roughly half of the patients were monitored for at least seven
years. Over the course of the study, 254 people, or 55 percent,
died. People who smoked at diagnosis were twice as likely to die as
nonsmokers, and people who reported any alcohol use were 68 percent
more likely to die, the study found.
“Head and neck cancer patients who smoke and also drink may be
creating more problems for themselves than they realize,” lead study
author Dr. Nosayaba Osazuwa-Peters of Saint Louis University School
of Medicine Osazuwa-Peters said by email.
Worldwide, head and neck squamous cell carcinoma is the seventh most
common type of cancer, according to the National Institutes of
Health. Each year, 600,000 new cases are diagnosed globally,
including about 50,000 in the United States.
These tumors are more common in men and people in their 50s and 60s,
but a growing number of cases are being diagnosed in younger
patients.
Even though smoking has long been linked to worse survival odds with
head and neck squamous cell carcinoma survival, the current study
offers fresh evidence of the connection and also suggests one
possible explanation: smokers are less likely to be married than
nonsmokers.
Unmarried people were 87 percent more likely to die with these
tumors than married people, researchers report in JAMA
Otolaryngology.
Study participants were diagnosed and treated between 1997 and 2012.
Overall, 56 percent were smokers at diagnosis and half of them were
married.
About 60 percent of the smokers were unmarried and 64 percent were
drinkers, the study found. By contrast, only 40 percent of the
nonsmokers were unmarried, and just 38 percent were drinkers.
Roughly half of the smokers survived for at least 7 years after
their diagnosis, whereas roughly half of the nonsmokers survived at
least 17 years.
The study wasn’t designed to prove whether or how lifestyle
decisions like smoking, drinking or getting married might influence
the odds of getting squamous cell carcinoma or dying from these
tumors.
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Researchers also lacked data on how changes in marital status might
have influenced shifts in smoking or drinking status. In addition,
they weren’t able to distinguish nonsmokers who recently quit from
people who never used cigarettes.
Still, said Osazuwa-Peters, “The fact is that smoking and drinking
alcohol combined cause more head and neck cancer than smoking or
drinking alcohol alone.”
Quitting at any time can improve how people respond to cancer
treatment and improve their survival odds, said Dr. Karl Kelsey,
director of the Center for Environmental Health and Technology at
Brown University in Providence, Rhode Island.
“A patient’s response to this cancer and healing from the very
invasive treatment of the disease will be greatly diminished in a
patient already compromised by dealing with the untoward effects of
smoking,” Kelsey, who wasn’t involved in the study, said by email.
“Quitting smoking at any time reduces your risk of poor outcomes.”
With this particular type of cancer, however, a large and growing
proportion of cases are caused by the sexually transmitted disease
human papilloma virus (HPV), Kelsey noted.
The connection between marriage and cancer risk in the study might
be connected to HPV infections, Kelsey said. Marriage is also
connected to a variety of other factors that contribute to the risk
of developing or dying from cancer such as education, employment,
and insurance status.
“Marriage may affect the biology of an individual in ways that we
have trouble measuring,” Kelsey said. “Married people may be
systematically happier, have more social support, better immune
systems, etc.”
SOURCE: http://bit.ly/2i98x3e JAMA Otolaryngology, online November
9, 2017.
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