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For Release: October 25, 2000
Smoking Increases Chances of Complications after Treatment for Cervical Cancer
Offering yet another reason not to smoke, a new study concludes that smoking substantially increases the risk of major gastrointestinal (GI) complications following radiation treatment for cervical cancer.
The study, which examined 3,489 patients with invasive cervical cancer from 1960 to 1994, considered the influence of smoking history, race, age and other characteristics and determined that smoking turned out to be the most powerful predictor of GI complications -- and in some cases bladder complications as well -- among patients.
"What we don't know is whether it's the smoking before treatment, the smoking during treatment or even smoking after treatment that's important," says Patricia Eifel, M.D., at M.D. Anderson Center in Houston, TX. "It may be just a summation of risks," she adds, "but we do know there is a strong correlation between packs-per-day smoked and the increased rate of complication."
Patients who never smoked were shown to have less than a two percent risk of developing major late complications in the small bowel. Comparatively, patients who smoked half a pack or less per day had a five percent chance; pack-a-day smokers had a nine percent chance and heavy smokers had a 13 percent chance of developing small bowel complications. Rectal and bladder complications were also increased by two- to three-fold in patients who smoked more than one pack per day.
The overall rate of major late GI complications was 6.6 percent at five years and 7.9 percent at 10 years. The GI complication rate of 1,172 smokers was more than twice that of 2,143 non-smokers.
Other factors that were significant, but not as conclusive as smoking, were race and weight. The GI complication rate of 712 hispanic women was substantially lower than that of 741 black women and 1,970 white women. Very thin patients -- body mass index less than 21 -- also had a higher rate of complications.
Dr. Eifel points out that nothing they've found so far explains the ethnic differences in rate of complication and that the subject deserves further study to determine its basis.
The study was presented October 25, at the American Society for Therapeutic Radiology and Oncology annual meeting in Boston, MA.
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