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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Null Results in Brief

Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer

Humberto Parada, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan E. Steck, Susan L. Teitelbaum, Alfred I. Neugut, Regina M Santella and Marilie D. Gammon
Humberto Parada
1Department of Epidemiology, University of North Carolina at Chapel Hill
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  • For correspondence: hparada@live.unc.edu
Patrick T. Bradshaw
2Division of Epidemiology, School of Public Health, University of California, Berkeley
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Lawrence S. Engel
3Division of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill
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Kathleen Conway
3Division of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill
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Susan E. Steck
4Epidemiology and Biostatistics, University of South Carolina
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Susan L. Teitelbaum
5Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai
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Alfred I. Neugut
6Department of Epidemiology, Department of Medicine, Columbia University
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Regina M Santella
7Department of Environmental Health Sciences, Columbia University
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Marilie D. Gammon
1Department of Epidemiology, University of North Carolina at Chapel Hill
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DOI: 10.1158/1055-9965.EPI-16-0658
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Abstract

Background: Environmental tobacco smoke (ETS) exposure is hypothesized to influence survival after breast cancer, but few studies have examined this association. Methods: A population-based cohort of women (N=1,508) diagnosed with first primary invasive or in situ breast cancer in 1996-1997 was interviewed shortly after diagnosis and again approximately 5 years later to assess ETS exposure, and women were followed for over 18 years using the National Death Index; 597 deaths (237 associated with breast cancer) were identified. Multivariable Cox regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for mortality among women with breast cancer as related to at-diagnosis and at-/post-diagnosis changes in ETS exposure. Results: There was little or no association between at-diagnosis ETS exposure and all-cause (HR=1.04, 95% CI=0.78-1.40) or breast cancer-specific (HR=0.98, 95% CI=0.63-1.52) mortality. Mortality was elevated among women who reported cessation in post-diagnosis ETS exposure up to one year before the follow-up assessment, for all-cause (HR=1.81, 95% CI=0.87-3.74) and breast cancer mortality (HR=1.89, 95% CI=0.68-5.24); however, estimates were imprecise. Conclusions: We found little evidence of an association between at-diagnosis ETS exposure and mortality after breast cancer. Post-diagnosis cessation of ETS exposure was positively associated with mortality, although we could not rule out chance and reverse causation as possible explanations. Impact: Exposure to ETS does not appear to influence mortality after breast cancer.

  • Received August 15, 2016.
  • Accepted August 26, 2016.
  • Copyright {copyright, serif}2016, American Association for Cancer Research.
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This OnlineFirst version was published on October 7, 2016
doi: 10.1158/1055-9965.EPI-16-0658

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Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer
Humberto Parada, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan E. Steck, Susan L. Teitelbaum, Alfred I. Neugut, Regina M Santella and Marilie D. Gammon
Cancer Epidemiol Biomarkers Prev October 7 2016 DOI: 10.1158/1055-9965.EPI-16-0658

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Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer
Humberto Parada, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan E. Steck, Susan L. Teitelbaum, Alfred I. Neugut, Regina M Santella and Marilie D. Gammon
Cancer Epidemiol Biomarkers Prev October 7 2016 DOI: 10.1158/1055-9965.EPI-16-0658
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