Smoking is associated with increased risk of myeloproliferative neoplasms: A general population-based cohort study

Kasper M. Pedersen; Marie Bak; Anders L. Sørensen; Ann-Dorthe Zwisler; Christina Ellervik; Morten K. Larsen; Hans C. Hasselbalch; Janne S. Tolstrup

doi:10.1002/cam4.1815

Smoking is associated with increased risk of myeloproliferative neoplasms: A general population-based cohort study

Kasper M. Pedersen^*, Marie Bak, Anders L. Sørensen, Ann-Dorthe Zwisler, Christina Ellervik, Morten K. Larsen, Hans C. Hasselbalch, Janne S. Tolstrup

^*Corresponding author for this work

Department of Clinical Medicine

21 Citations (Scopus)

32 Downloads (Pure)

Abstract

Background: Former studies on smoking as a risk factor for Philadelphia-negative myeloproliferative neoplasms (MPNs) have mainly been carried out in women's cohorts and studies with various definitions of MPNs. Herein, we conducted a cohort study with register-based follow-up of a general population from Denmark, to validate and substantiate prior observations. Methods: In the Danish Health Examination Survey cohort, we used the Cox proportional-hazards model adjusted for age, sex, body mass index, and level of education, to calculate hazard ratios (HRs), to investigate, whether daily smokers or occasional/ex-smokers had an increased risk of MPNs compared to never-smokers. Results: From the time of data collection (September 2007 to October 2008) until 1 January 2015, 70 individuals were diagnosed with MPNs among 75 896 study participants. Similar results were observed in both the age and sex adjusted analysis and the multivariable analysis. The multivariable HR of any MPN diagnosis for daily smokers was 2.5 (95% CI: 1.3-5.0). For essential thrombocytosis, polycythemia vera, myelofibrosis, and MPN-unclassified, the HRs were 1.8 (95% CI: 0.5-5.8), 1.7 (95% CI: 0.5-5.8), 4.3 (95% CI: 0.9-19), and 6.2 (95% CI: 1.5-25), respectively. Among occasional/ex-smokers the corresponding HRs were 1.9 (95% CI: 1.1-3.3), 1.5 (95% CI: 0.6-3.7), 0.8 (95% CI: 0.3-2.4), 0.9 (95% CI: 0.2-4.4), and 6.2 (95% CI: 1.8-21). Participants, who smoked >15 g/day, had an overall HR of 3.4 (95% CI: 1.4-8.2) for any MPN diagnosis, while participants who smoked ≤15 g/day, had an overall HR of 2.1 (95% CI: 0.9-4.7). Conclusion: Smoking was associated with MPN development when comparing smokers and never-smokers. Further studies investigating smoking in MPNs are warranted to substantiate our findings.

Original language	English
Journal	Cancer Medicine
Volume	7
Issue number	11
Pages (from-to)	5796-5802
Number of pages	7
ISSN	2045-7634
DOIs	https://doi.org/10.1002/cam4.1815
Publication status	Published - 2018

Keywords

epidemiology
essential thrombocythemia
myeloproliferative neoplasms
polycythemia vera
primary myelofibrosis
tobacco smoking

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Smoking is associated with increased risk of myeloproliferative neoplasms: A general population‐based cohort studyFinal published version, 239 KBLicence: CC BY

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@article{e5e9fdeb710d4db0b3247a1f4b9743f3,

title = "Smoking is associated with increased risk of myeloproliferative neoplasms: A general population-based cohort study",

abstract = "Background: Former studies on smoking as a risk factor for Philadelphia-negative myeloproliferative neoplasms (MPNs) have mainly been carried out in women's cohorts and studies with various definitions of MPNs. Herein, we conducted a cohort study with register-based follow-up of a general population from Denmark, to validate and substantiate prior observations. Methods: In the Danish Health Examination Survey cohort, we used the Cox proportional-hazards model adjusted for age, sex, body mass index, and level of education, to calculate hazard ratios (HRs), to investigate, whether daily smokers or occasional/ex-smokers had an increased risk of MPNs compared to never-smokers. Results: From the time of data collection (September 2007 to October 2008) until 1 January 2015, 70 individuals were diagnosed with MPNs among 75 896 study participants. Similar results were observed in both the age and sex adjusted analysis and the multivariable analysis. The multivariable HR of any MPN diagnosis for daily smokers was 2.5 (95% CI: 1.3-5.0). For essential thrombocytosis, polycythemia vera, myelofibrosis, and MPN-unclassified, the HRs were 1.8 (95% CI: 0.5-5.8), 1.7 (95% CI: 0.5-5.8), 4.3 (95% CI: 0.9-19), and 6.2 (95% CI: 1.5-25), respectively. Among occasional/ex-smokers the corresponding HRs were 1.9 (95% CI: 1.1-3.3), 1.5 (95% CI: 0.6-3.7), 0.8 (95% CI: 0.3-2.4), 0.9 (95% CI: 0.2-4.4), and 6.2 (95% CI: 1.8-21). Participants, who smoked >15 g/day, had an overall HR of 3.4 (95% CI: 1.4-8.2) for any MPN diagnosis, while participants who smoked ≤15 g/day, had an overall HR of 2.1 (95% CI: 0.9-4.7). Conclusion: Smoking was associated with MPN development when comparing smokers and never-smokers. Further studies investigating smoking in MPNs are warranted to substantiate our findings.",

keywords = "epidemiology, essential thrombocythemia, myeloproliferative neoplasms, polycythemia vera, primary myelofibrosis, tobacco smoking",

author = "Pedersen, {Kasper M.} and Marie Bak and S{\o}rensen, {Anders L.} and Ann-Dorthe Zwisler and Christina Ellervik and Larsen, {Morten K.} and Hasselbalch, {Hans C.} and Tolstrup, {Janne S.}",

year = "2018",

doi = "10.1002/cam4.1815",

language = "English",

volume = "7",

pages = "5796--5802",

journal = "Cancer Medicine",

issn = "2045-7634",

publisher = "JohnWiley & Sons Ltd",

number = "11",

}

TY - JOUR

T1 - Smoking is associated with increased risk of myeloproliferative neoplasms

T2 - A general population-based cohort study

AU - Pedersen, Kasper M.

AU - Bak, Marie

AU - Sørensen, Anders L.

AU - Zwisler, Ann-Dorthe

AU - Ellervik, Christina

AU - Larsen, Morten K.

AU - Hasselbalch, Hans C.

AU - Tolstrup, Janne S.

PY - 2018

Y1 - 2018

N2 - Background: Former studies on smoking as a risk factor for Philadelphia-negative myeloproliferative neoplasms (MPNs) have mainly been carried out in women's cohorts and studies with various definitions of MPNs. Herein, we conducted a cohort study with register-based follow-up of a general population from Denmark, to validate and substantiate prior observations. Methods: In the Danish Health Examination Survey cohort, we used the Cox proportional-hazards model adjusted for age, sex, body mass index, and level of education, to calculate hazard ratios (HRs), to investigate, whether daily smokers or occasional/ex-smokers had an increased risk of MPNs compared to never-smokers. Results: From the time of data collection (September 2007 to October 2008) until 1 January 2015, 70 individuals were diagnosed with MPNs among 75 896 study participants. Similar results were observed in both the age and sex adjusted analysis and the multivariable analysis. The multivariable HR of any MPN diagnosis for daily smokers was 2.5 (95% CI: 1.3-5.0). For essential thrombocytosis, polycythemia vera, myelofibrosis, and MPN-unclassified, the HRs were 1.8 (95% CI: 0.5-5.8), 1.7 (95% CI: 0.5-5.8), 4.3 (95% CI: 0.9-19), and 6.2 (95% CI: 1.5-25), respectively. Among occasional/ex-smokers the corresponding HRs were 1.9 (95% CI: 1.1-3.3), 1.5 (95% CI: 0.6-3.7), 0.8 (95% CI: 0.3-2.4), 0.9 (95% CI: 0.2-4.4), and 6.2 (95% CI: 1.8-21). Participants, who smoked >15 g/day, had an overall HR of 3.4 (95% CI: 1.4-8.2) for any MPN diagnosis, while participants who smoked ≤15 g/day, had an overall HR of 2.1 (95% CI: 0.9-4.7). Conclusion: Smoking was associated with MPN development when comparing smokers and never-smokers. Further studies investigating smoking in MPNs are warranted to substantiate our findings.

AB - Background: Former studies on smoking as a risk factor for Philadelphia-negative myeloproliferative neoplasms (MPNs) have mainly been carried out in women's cohorts and studies with various definitions of MPNs. Herein, we conducted a cohort study with register-based follow-up of a general population from Denmark, to validate and substantiate prior observations. Methods: In the Danish Health Examination Survey cohort, we used the Cox proportional-hazards model adjusted for age, sex, body mass index, and level of education, to calculate hazard ratios (HRs), to investigate, whether daily smokers or occasional/ex-smokers had an increased risk of MPNs compared to never-smokers. Results: From the time of data collection (September 2007 to October 2008) until 1 January 2015, 70 individuals were diagnosed with MPNs among 75 896 study participants. Similar results were observed in both the age and sex adjusted analysis and the multivariable analysis. The multivariable HR of any MPN diagnosis for daily smokers was 2.5 (95% CI: 1.3-5.0). For essential thrombocytosis, polycythemia vera, myelofibrosis, and MPN-unclassified, the HRs were 1.8 (95% CI: 0.5-5.8), 1.7 (95% CI: 0.5-5.8), 4.3 (95% CI: 0.9-19), and 6.2 (95% CI: 1.5-25), respectively. Among occasional/ex-smokers the corresponding HRs were 1.9 (95% CI: 1.1-3.3), 1.5 (95% CI: 0.6-3.7), 0.8 (95% CI: 0.3-2.4), 0.9 (95% CI: 0.2-4.4), and 6.2 (95% CI: 1.8-21). Participants, who smoked >15 g/day, had an overall HR of 3.4 (95% CI: 1.4-8.2) for any MPN diagnosis, while participants who smoked ≤15 g/day, had an overall HR of 2.1 (95% CI: 0.9-4.7). Conclusion: Smoking was associated with MPN development when comparing smokers and never-smokers. Further studies investigating smoking in MPNs are warranted to substantiate our findings.

KW - epidemiology

KW - essential thrombocythemia

KW - myeloproliferative neoplasms

KW - polycythemia vera

KW - primary myelofibrosis

KW - tobacco smoking

U2 - 10.1002/cam4.1815

DO - 10.1002/cam4.1815

M3 - Journal article

C2 - 30318865

AN - SCOPUS:85054925284

SN - 2045-7634

VL - 7

SP - 5796

EP - 5802

JO - Cancer Medicine

JF - Cancer Medicine

IS - 11

ER -

Smoking is associated with increased risk of myeloproliferative neoplasms: A general population-based cohort study

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Keywords

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