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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 Jr, 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 Jr
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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  • For correspondence: hparada@live.unc.edu
Patrick T. Bradshaw
2Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California.
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Lawrence S. Engel
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Kathleen Conway
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Susan E. Steck
3Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina.
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Susan L. Teitelbaum
4Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
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Alfred I. Neugut
5Department of Epidemiology, Columbia University, New York, New York.
6Department of Medicine, Columbia University, New York, New York.
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Regina M. Santella
7Department of Environmental Health Sciences, Columbia University, New York, New York.
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Marilie D. Gammon
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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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 to 1997 was interviewed shortly after diagnosis and again approximately 5 years later to assess ETS exposure, and women were followed for more than 18 years using the National Death Index; 597 deaths (237 associated with breast cancer) were identified. Multivariable Cox regression was used to estimate adjusted HRs and 95% confidence intervals (CI) for mortality among women with breast cancer as related to at-diagnosis and at-/postdiagnosis 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 postdiagnosis ETS exposure up to 1 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. Postdiagnosis 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. Cancer Epidemiol Biomarkers Prev; 26(2); 1–3. ©2016 AACR.

  • Received August 15, 2016.
  • Accepted August 26, 2016.
  • ©2016 American Association for Cancer Research.
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This OnlineFirst version was published on January 24, 2017
doi: 10.1158/1055-9965.EPI-16-0658

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Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer
Humberto Parada Jr, 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 January 24 2017 DOI: 10.1158/1055-9965.EPI-16-0658

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Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer
Humberto Parada Jr, 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 January 24 2017 DOI: 10.1158/1055-9965.EPI-16-0658
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