(HealthDay News) — Longer duration and more pack-years of cigarette smoking are associated with a higher risk for recurrence of non-muscle-invasive bladder cancer (NMIBC), according to a study published in JAMA Network Open.

Researchers examined associations between recurrence and progression of NMIBC and the use of tobacco (cigarettes, pipes, and cigars), e-cigarettes, and marijuana. The analysis included 1472 patients with NMIBC diagnosed from 2015 to 2019 and followed for 26.4 months.

The researchers found that longer cigarette smoking duration and more pack-years were associated with a higher risk of recurrence in a dose-dependent manner. The highest risks were seen for patients who had smoked for at least 40 years (hazard ratio, 2.36) or at least 40 pack-years (hazard ratio, 1.97).


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Recurrence risk was not associated with having ever smoked, being a former or current cigarette smoker, and years since quitting smoking. Furthermore, there were no associations observed for pipes, cigars, e-cigarettes, or marijuana.

Just over half of 102 patients offered a smoking cessation intervention (53.8%) received an intervention after diagnosis. Female patients were more likely than male patients to participate in such interventions (76.7% vs 44.7%).

“Cigarette smoking remains a critical exposure before and after diagnosis in survivors of NMIBC,” the authors wrote.

Abstract/Full Text