Table 5.

Associations between ACS guidelines score and outcomes, stratified by smoking history

Any incident cancerAll-cause mortalityCancer-specific mortality
EventsHR (95% CI)aEventsHR (95% CI)1EventsHR (95% CI)1
Smoking historyACS scoren (%)n (%)n (%)
Never
0–31,358 (11.9)1.001,139 (9.96)1.00341 (3.01)1.00
4–51,789 (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)
6–8845 (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<0.0010.004
Trendb0.96 (0.94–0.98)0.92 (0.90–0.94)0.94 (0.90–0.98)
<5 pack-years
0–3425 (12.3)1.00315 (9.11)1.0096 (2.80)1.00
4–5500 (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)
6–8251 (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)
Ptrendb0.1300.0150.607
Trendb0.97 (0.94–1.01)0.94 (0.90–0.99)1.02 (0.94–1.11)
5–19 pack-years
0–3472 (13.4)1.00351 (9.99)1.00119 (3.42)1.00
4–5607 (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)
6–8234 (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)
Ptrendb0.2480.0330.197
Trendb0.98 (0.94–1.02)0.95 (0.91–1.00)0.95 (0.89–1.03)
20+ pack-years
0–3988 (18.0)1.001,057 (19.3)1.00389 (7.24)1.00
4–5866 (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)
6–8297 (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)
Ptrendb0.010<0.0010.022
Trendb0.96 (0.94–0.99)0.93 (0.90–0.95)0.95 (0.90–0.99)
Test for interactioncP = 0.805P = 0.602P = 0.488
  • aAdjusted 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).

  • bTrend tested by modeling ACS score as an ordinal variable (0–8).

  • cLikelihood ratio test for interaction between smoking and ACS guidelines score (continuous) on each outcome.