Chidharla A, Rabbani R, Agarwal K, Abdelwahed S, Bhandari R, Manaktala PS, Singh A, Patel K, Singh P, Mehta D, Malik P, Patel U, Pillai S, and Koritala T. 1825P Prevalence of cancer among e-cigarette smokers compared to non-smokers: A retrospective cross-sectional survey study of NHANES-CDC. Ann Oncol 2021; 32:S1236.
Background: Current e-cigarette use has been rising, assuming as a safe alternative to traditional smoking. Therefore, we aim to evaluate the prevalence of cancer and types of cancers amongst e-cigarette and traditional smokers.
Methods: A retrospective cross-sectional survey study was performed using NHANES (National Health And Nutrition Examination Survey) database from 2015 to 2018. History of cancer (MCQ220), type of cancers (MCQ230a), and smoking status (E-cigarette: SMQ900 or SMQ905 and Traditional smoking: SMQ020) were identified. Univariate and multivariable logistic regression analysis was performed to find out prevalence and association between e-cigarette smoking and cancer. We have excluded respondents with dual smoking.
Results: Out of 154,856 participants, 7756 (5.01%) were e-cigarette users, 48625 (31.4%) were traditional smokers, 98475 (63.59%) were non-smokers. Females (49 vs 38%), Mexican Americans (20 vs 13%), high annual household income (>$100,000: 23 vs 15%) were having a higher prevalence of e-cigarette smoking in comparison with traditional smoking. (p<0.0001) Prevalence of cancer (any type) was 11.61%. Cancer prevalence was higher amongst traditional smokers in comparison with e-cigarette smokers. (16.77 vs 2.32%; p<0.0001) E-cigarette smokers were younger at the diagnosis of 1st cancer in comparison with traditional smokers. (median: 45 vs 63-years; p<0.0001) Cervical (21.99 vs 2.01%), thyroid (10.64 vs 2.45%), leukemias (8.51 vs 1.08%), and breast (12.06 vs 12.01%) cancers were more prevalent amongst e-cigarette smokers in comparison to traditional smokers. (p<0.0001) In adjusted multivariable regression analysis, e-cigarette smokers [aOR: 1.3 (95%CI: 1.32-1.33); p<0.0001] and traditional smokers [1.6 (1.64-1.65); p<0.0001] were having higher odds of prevalence of cancer in comparison with non-smoker.
Conclusions: E-cigarette smokers had an early age of cancer onset and higher odds of cancer prevalence. Females had higher use of e-cigarette and cervical, thyroid, and breast cancers were prevalent amongst e-cigarette users. More prospective studies should be planned to mitigate the risk and before considering e-cigarette as a safe alternative to traditional smoking.