Smoking and survival among Kentucky women diagnosed with invasive cervical cancer: 1995-2005

Ann L. Coker, Christopher P. DeSimone, Katherine S. Eggleston, Claudia Hopenhayn, Jaclyn Nee, Thomas Tucker

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Objectives: To determine whether smokers with cervical cancer were more likely to die from cervical cancer compared with non smokers after adjusting for confounding factors. Methods: A population-based survival analysis was conducted among 2661 women diagnosed with invasive cervical cancer and reported to the Kentucky Cancer Registry from 1995-2005 and linked with state vital records and the National Death Index through 12/31/2005. A standard Kaplan - Meier approach was used in this survival analysis and Cox Proportional Hazards modeling was used to estimate adjusted hazard [aHR] ratios and 95% confidence intervals [CI] for smoking and survival for all cause and cervical cancer specific cause of death. Results: Almost half of women diagnosed with cervical cancer (48.6%) were known to be current smokers based the medical record review and reporting to KCR. For another 19.4% no tobacco status was documented (missing) and 32.1% were known non smokers. After adjustment for age and stage at diagnosis, cell type, rural residence, race, insurance coverage, and treatment received, current smoker were 35% more likely to die of any cause (aHR = 1.35; 95% CI = 1.17-1.56) and 21% more likely to die of cervical cancer (aHR = 1.21; 95% CI = 1.01-1.46) compared with known non smoking cases. Conclusion: These data strongly suggest that smoking reduces cervical cancer survival.

Original languageEnglish
Pages (from-to)365-369
Number of pages5
JournalGynecologic Oncology
Issue number2
StatePublished - Feb 2009

Bibliographical note

Funding Information:
The Kentucky Cancer Registry is supported by funds from both the CDC National Program of Cancer Registries (Grant # 5U58DP000810-02) and the NCI Surveillance Epidemiology and End Results Program (Contract # NO1-PC-54403).

Funding Information:
We conducted a population-based survival analysis among 2661 women diagnosed with invasive cervical cancer and reported to the KCR, a state wide population based registry funded by National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program and the Centers for Disease Control and Prevention's National Program of Cancer Registries. The KCR is mandated by legislation passed by the General Assembly in 1990 to record all cases of cancer in the Commonwealth (with the exception of non-melanoma skin cancer). KCR has received gold certification from the North American Association of Central Cancer Registries every year since the formal certification was established, and has over 99% case ascertainment.


  • Cervical cancer
  • Cigarette smoking
  • Epidemiology
  • Survival
  • Survival analysis

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology


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