Table 5.
Associations between ACS guidelines score and outcomes, stratified by smoking history
| Any incident cancer | All-cause mortality | Cancer-specific mortality | |||||
|---|---|---|---|---|---|---|---|
| Smoking history | ACS score | Events n (%) |
HR (95% CI)a | Events n (%) |
HR (95% CI)1 | Events n (%) |
HR (95% CI)1 |
| Never | |||||||
| 0–3 | 1,358 (11.9) | 1.00 | 1,139 (9.96) | 1.00 | 341 (3.01) | 1.00 | |
| 4–5 | 1,789 (11.7) | 0.92 (0.86–0.99) | 1,417 (9.26) | 0.84 (0.78–0.91) | 437 (2.88) | 0.89 (0.77–1.03) | |
| 6–8 | 845 (11.2) | 0.84 (0.77–0.92) | 603 (7.97) | 0.71 (0.64–0.78) | 189 (2.52) | 0.76 (0.63–0.91) | |
| Ptrendb | <0.001 | <0.001 | 0.004 | ||||
| Trendb | 0.96 (0.94–0.98) | 0.92 (0.90–0.94) | 0.94 (0.90–0.98) | ||||
| <5 pack-years | |||||||
| 0–3 | 425 (12.3) | 1.00 | 315 (9.11) | 1.00 | 96 (2.80) | 1.00 | |
| 4–5 | 500 (11.6) | 0.87 (0.76–0.99) | 359 (8.35) | 0.88 (0.75–1.02) | 111 (2.61) | 0.90 (0.68–1.19) | |
| 6–8 | 251 (12.1) | 0.89 (0.76–1.05) | 156 (7.53) | 0.80 (0.65–0.97) | 63 (3.06) | 1.09 (0.79–1.52) | |
| Ptrendb | 0.130 | 0.015 | 0.607 | ||||
| Trendb | 0.97 (0.94–1.01) | 0.94 (0.90–0.99) | 1.02 (0.94–1.11) | ||||
| 5–19 pack-years | |||||||
| 0–3 | 472 (13.4) | 1.00 | 351 (9.99) | 1.00 | 119 (3.42) | 1.00 | |
| 4–5 | 607 (14.4) | 1.01 (0.90–1.15) | 443 (10.5) | 0.97 (0.84–1.12) | 154 (3.69) | 1.02 (0.80–1.30) | |
| 6–8 | 234 (12.8) | 0.86 (0.73–1.01) | 152 (8.33) | 0.78 (0.64–0.94) | 50 (2.76) | 0.75 (0.53–1.05) | |
| Ptrendb | 0.248 | 0.033 | 0.197 | ||||
| Trendb | 0.98 (0.94–1.02) | 0.95 (0.91–1.00) | 0.95 (0.89–1.03) | ||||
| 20+ pack-years | |||||||
| 0–3 | 988 (18.0) | 1.00 | 1,057 (19.3) | 1.00 | 389 (7.24) | 1.00 | |
| 4–5 | 866 (17.7) | 0.93 (0.85–1.02) | 855 (17.4) | 0.84 (0.77–0.92) | 301 (6.25) | 0.82 (0.70–0.95) | |
| 6–8 | 297 (17.0) | 0.87 (0.76–0.99) | 259 (14.8) | 0.71 (0.62–0.82) | 106 (6.18) | 0.80 (0.64–1.00) | |
| Ptrendb | 0.010 | <0.001 | 0.022 | ||||
| Trendb | 0.96 (0.94–0.99) | 0.93 (0.90–0.95) | 0.95 (0.90–0.99) | ||||
| Test for interactionc | P = 0.805 | P = 0.602 | P = 0.488 | ||||
Adjusted for age (continuous), education (≤high school, some college, ≥college), NSAID use at baseline (yes, no), aspirin use at baseline (yes, no), unopposed estrogen use (never, former, current), estrogen + progestin use (never, former, current), multivitamin use at baseline (yes, no), race/ethnicity (NHW, Hispanic, black, Asian, Native American, other), total energy intake (continuous), parous (yes, no, unknown), mammogram (ever, never), colonoscopy/sigmoidoscopy (ever, never), family history (mother/father, full-blooded sister/brother, daughter/son, grandmother) of cancer (yes, no, unknown), and having a current healthcare provider (yes, no).
Trend tested by modeling ACS score as an ordinal variable (0–8).
Likelihood ratio test for interaction between smoking and ACS guidelines score (continuous) on each outcome.