Medical Oncology

, 32:339 | Cite as

Effect of smoking on survival from non-small cell lung cancer: a retrospective Veterans’ Affairs Central Cancer Registry (VACCR) cohort analysis

  • Vijaya Raj Bhatt
  • Rishi Batra
  • Peter T. Silberstein
  • Fausto R. LoberizaJr.
  • Apar Kishor GantiEmail author
Original Paper


Although a well-established risk factor for lung cancer, the impact of smoking on the survival of non-small cell lung cancer (NSCLC) is not well known. We performed a retrospective analysis of the Veteran’s Affairs Comprehensive Cancer Registry of NSCLC patients. Smoking status was categorized as never smoker, past smoker and current smoker based on self-reported history. Multivariate analysis was performed to evaluate the impact of smoking on overall survival (OS) from NSCLC. The study population (n = 61,440) comprised predominantly of males (98 %) and Caucasians (81 %). The median age at diagnosis was 68 years (range 22–108 years). Current smokers were diagnosed with NSCLC at a younger age (65 years) compared to never smokers (71 years) and past smokers (72 years) (p < 0.001). On multivariate analysis, current smokers (n = 34,613) [Hazard ratio (HR) 1.059; 95 % confidence interval (CI) 1.012–1.108], but not past smokers (n = 23,864) (HR 1.008; 95 % CI 0.962–1.056), had worse OS for Stage III and IV NSCLC, compared to never smokers (n = 2,963). Smoking status was not prognostic in stages I and II NSCLC. Current smokers were diagnosed with NSCLC at a younger age than never smokers. Although current smoking was associated with worse prognosis, especially in stages III and IV, the impact of smoking status on OS was modest.


Non-small cell lung cancer Tobacco Smoking Outcomes Survival 



The facilities of the VA-Nebraska Western Iowa Health Care System were used during the course of this study.

Conflict of interest

There are no conflicts of interest associated with the contents of this manuscript.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Vijaya Raj Bhatt
    • 1
  • Rishi Batra
    • 2
  • Peter T. Silberstein
    • 3
    • 4
  • Fausto R. LoberizaJr.
    • 1
  • Apar Kishor Ganti
    • 1
    • 3
    Email author
  1. 1.Division of Oncology-Hematology, Department of Internal MedicineUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of Internal MedicineUniversity of Nebraska Medical CenterOmahaUSA
  3. 3.Department of Internal MedicineVeteran’s Affairs Nebraska-Western Iowa Health Care SystemOmahaUSA
  4. 4.Department of Internal MedicineCreighton University Medical CenterOmahaUSA

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