Evidence map›Paper›PMID 37633678›Full record

ArticleThe Lancet. Public health2023

Association between duration of smoking abstinence before non-small-cell lung cancer diagnosis and survival: a retrospective, pooled analysis of cohort studies.

Aline F Fares, Yao Li, Mei Jiang, M Catherine Brown, Andrew C L Lam, Reenika Aggarwal, Sabine Schmid, Natasha B Leighl, Frances A Shepherd, Zhichao Wang and 45 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  6. Article
  7. Article
  8. Review
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  10. "Because That is the Right Thing to do": A Focus Group Study of Australian Expert Perspectives on Offering Smoking Cessation Support in Lung Cancer Screening.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
    Article
  11. Article
  12. Article
  13. Review
  14. Non-small-cell lung cancer.Nature reviews. Disease primers · 2024
    Review
  15. Article
  16. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024
    Review
  17. Article
  18. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

55 authors at 20 institutions in 14 countries.

Aline F FaresPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Division of Medical Oncology, Faculty of Medicine of São José do Rio Preto, São Paulo, Brazil.
Yao LiDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Mei JiangPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
M Catherine BrownPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
Andrew C L LamPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
Reenika AggarwalPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
Sabine SchmidPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Universitätsklinik für Medizinische Onkologie, Inselspital Bern, Bern, Switzerland.
Natasha B LeighlPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
Frances A ShepherdPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
Zhichao WangDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Division of Pulmonary and Critical Care Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Nancy DiaoHarvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
Angela S WenzlaffBarbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
Juntao XieDepartment of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Takashi KohnoDivision of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan.
Neil E CaporasoNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Curtis HarrisLaboratory of Human Carcinogenesis, Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA.
Hongxia MaDepartment of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
Matthew J BarnettPublic Health Sciences, Biostatistics Program, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Leticia Ferro LealMolecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
G Fernandez-TardonUniversity Institute of Oncology of Asturias-Cajastur Social Programme, University of Oviedo, Oviedo, Spain; Health Research Institute of Asturias, Oviedo, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Oviedo, Spain.
Mónica Pérez-RíosDepartment of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
Michael P A DaviesRoy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
Fiona TaylorDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK; Weston Park Cancer Centre, Sheffield Teaching Hospital Foundation Trust, Sheffield, UK.
Ben SchöttkerDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Network of Aging Research, Heidelberg University, Heidelberg, Germany.
Paul BrennanGenomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France.
David ZaridzeN N Blokhin National Medical Research Centre of Oncology, Moscow, Russia.
Ivana HolcatovaInstitute of Public Health and Preventive Medicine and Department of Oncology, Second Faculty of Medicine and University Hospital Motol, Charles University, Prague, Czech Republic.
Jolanta LissowskaDepartment of Cancer Epidemiology and Prevention, M Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Beata ŚwiątkowskaNofer Institute of Occupational Medicine, Łódź, Poland.
Dana MatesNational Institute of Public Health, Bucharest, Romania.
Milan SavicDepartment of Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia.
Hermann BrennerDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany; National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany.
Angeline AndrewDartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Angela CoxDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
John K FieldRoy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
Alberto Ruano-RavinaDepartment of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Sanjay S SheteM D Anderson Cancer Center, University of Texas, Houston, TX, USA.
Adonina TardonUniversity Institute of Oncology of Asturias-Cajastur Social Programme, University of Oviedo, Oviedo, Spain; Health Research Institute of Asturias, Oviedo, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Oviedo, Spain.
Ying WangAmerican Cancer Society, Atlanta, GA, USA.
Loic Le MarchandUniversity of Hawai'i Cancer Centre, University of Hawai'i, Honolulu, HI, USA.
Rui Manuel ReisMolecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil; Life and Health Sciences Research Institute, Medical School, University of Minho, Braga, Portugal; Life and Health Sciences Research Institute-Biomaterials, Biodegradables and Biomimetics Research Group Associate Laboratory, Braga, Portugal.
Matthew B SchabathH Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Chu ChenProgram in Epidemiology, Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Hongbing ShenDepartment of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
Brid M RyanLaboratory of Human Carcinogenesis, Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA.
Maria Teresa LandiNational Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Kouya ShiraishiDivision of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan; Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan.
Jie ZhangDepartment of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Ann G SchwartzBarbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
Ming S TsaoPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
David C ChristianiHarvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
Ping YangDepartment of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Rayjean J HungDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health Systems, Toronto, ON, Canada.
Wei XuPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Electronic address: wei.xu@uhnres.utoronto.ca.
Geoffrey LiuPrincess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
University Health Network · CANational Institutes of Health · USUniversity of Toronto · CAFred Hutch Cancer Center · USFudan University Shanghai Cancer Center · CNHarvard University · USHospital de Câncer de Barretos · BRMayo Clinic in Florida · USNanjing Medical University · CNPublic Health Ontario · CARoy Castle Lung Cancer Foundation · GBThe Barbara Ann Karmanos Cancer Institute · USUniversidade de Santiago de Compostela · ESUniversity of Sheffield · GBAmerican Cancer Society · USCentar za Promociju Nauke · RSCentre international de recherche sur le cancer · FRCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública · ESCharles University · CZDartmouth–Hitchcock Medical Center · US

Funding

TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI John L. Cleveland · 1998 to 2026
$93.5M
Translating Molecular and Clinical Data to Population Lung Cancer Risk AssessmentU19CA203654 · NCI · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI Christopher I. Amos · 2017 to 2026
$23.7M
THE CAROTENE AND RETINOL EFFICACY TRIAL (CARET)U01CA063673 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI GOODMAN, GARY E · 1994 to 2006
$13.0M
The Boston Lung Cancer Survival CohortU01CA209414 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI David C Christiani · 2017 to 2026
$12.2M
Statistical Methods for Analysis of Massive Genetic and Genomic Data in Cancer ResearchR35CA197449 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI XIHONG LIN · 2015 to 2026
$10.9M
Infrastructure Support and Pilot Tissue Collection for the CARET BiorepositoryU01CA167462 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI NEUHOUSER, MARIAN L · 2018 to 2022
$2.9M
INFRASRUCTURE SUPPORT AND DATA ENHANCEMENTS FOR THE CARET BIOREPOSITORYUM1CA167462 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI GOODMAN, GARY E · 2013 to 2017
$2.8M
NCI NIH HHS P30 CA076292NCI NIH HHS R35 CA197449NCI NIH HHS U01 CA063673NCI NIH HHS U01 CA167462NCI NIH HHS U01 CA209414NCI NIH HHS U19 CA203654NCI NIH HHS UM1 CA167462NHLBI NIH HHS HHSN268201600001CNHLBI NIH HHS HHSN268201600002CNHLBI NIH HHS HHSN268201600003CNHLBI NIH HHS HHSN268201600004CNHLBI NIH HHS HHSN268201600018CWorld Health Organization 001
6 · The paper itself

Abstract

backgroundThe association between duration of smoking abstinence before non-small-cell lung cancer (NSCLC) diagnosis and subsequent survival can influence public health messaging delivered in lung-cancer screening. We aimed to assess whether the duration of smoking abstinence before diagnosis of NSCLC is associated with improved survival.

methodsIn this retrospective, pooled analysis of cohort studies, we used 26 cohorts participating in Clinical Outcomes Studies of the International Lung Cancer Consortium (COS-ILCCO) at 23 hospitals. 16 (62%) were from North America, six (23%) were from Europe, three (12%) were from Asia, and one (4%) was from South America. Patients enrolled were diagnosed between June 1, 1983, and Dec 31, 2019. Eligible patients had smoking data before NSCLC diagnosis, epidemiological data at diagnosis (obtained largely from patient questionnaires), and clinical information (retrieved from medical records). Kaplan-Meier curves and multivariable Cox models (ie, adjusted hazard ratios [aHRs]) were generated with individual, harmonised patient data from the consortium database. We estimated overall survival for all causes, measured in years from diagnosis date until the date of the last follow-up or death due to any cause and NSCLC-specific survival.

findingsOf 42 087 patients with NSCLC in the COS-ILCCO database, 21 893 (52·0%) of whom were male and 20 194 (48·0%) of whom were female, we excluded 4474 (10·6%) with missing data. Compared with current smokers (15 036 [40·0%] of 37 613), patients with 1-3 years of smoking abstinence before NSCLC diagnosis (2890 [7·7%]) had an overall survival aHR of 0·92 (95% CI 0·87-0·97), patients with 3-5 years of smoking abstinence (1114 [3·0%]) had an overall survival aHR of 0·90 (0·83-0·97), and patients with more than 5 years of smoking abstinence (10 841 [28·8%]) had an overall survival aHR of 0·90 (0·87-0·93). Improved NSCLC-specific survival was observed in 4301 (44%) of 9727 patients who had quit cigarette smoking and was significant at abstinence durations of more than 5 years (aHR 0·87, 95% CI 0·81-0·93). Results were consistent across age, sex, histology, and disease-stage distributions.

interpretationIn this large, pooled analysis of cohort studies across Asia, Europe, North America, and South America, overall survival was improved in patients with NSCLC whose duration of smoking abstinence before diagnosis was as short as 1 year. These findings suggest that quitting smoking can improve overall survival, even if NSCLC is diagnosed at a later lung-cancer screening visit. These findings also support the implementation of public health smoking cessation strategies at any time.

fundingThe Alan B Brown Chair, The Posluns Family Fund, The Lusi Wong Fund, and the Princess Margaret Cancer Foundation.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsCohort StudiesFemaleHumansMaleRetrospective StudiesSmoking

Identifiers

PMID37633678
PMCPMC10540150
OpenAlexW4386118442

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.