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. 2018 Nov;7(11):5796-5802.
doi: 10.1002/cam4.1815. Epub 2018 Oct 14.

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

Kasper M Pedersen  1 , Marie Bak  1 , Anders L Sørensen  1   2 , Ann-Dorthe Zwisler  3 , Christina Ellervik  4   5 , Morten K Larsen  1   6 , Hans C Hasselbalch  1 , Janne S Tolstrup  7
Affiliations

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

Kasper M Pedersen et al. Cancer Med. 2018 Nov.

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.

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