Association between smoking cessation and recurrence of gastric cancer: A retrospective study based on the National Health and Nutrition Examination Surveys (NHANES) 1999-2018

Background: Gastric cancer (GC) is easy to recur after operation and the prognosis is poor. Smoking is closely related to the risk of multiple malignant tumors, but the relationship between smoking and the recurrence of GC is not clear. The purpose of this study is to further explore the relationship between smoking cessation and the recurrence of GC based on the data of the National Health and Nutrition Examination Survey (NHANES). Gastric cancer; Smoking; Smoking cessation; recurrence Methods: Based on ten surveys of NHANES (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, 2017-2018), the patients with GC were included and matched with non-cancer individuals according to age and sex to analyze the factors related to GC. The patients with GC were further divided into recurrence group and non-recurrence group, and the factors related to recurrence were analyzed by multivariate logistic regression. Results: Multivariate logistic regression analysis showed that there was significant statistical correlation between heavy drinking, smoking history and GC. The average age, the ratio of male, the ratio of heavy drinking and the ratio of smoking history in the recurrence group were significantly higher than those in the non-recurrence group (P<0.05). The recurrence rate of GC patients without smoking cessation was the highest, while the recurrence rate of GC patients without smoking history was the lowest (P<0.05). Multivariate logistic regression analysis showed that age, male, heavy drinking and smoking history were closely related to the recurrence of GC (P<0.05).   Conclusion: Smoking is closely related to the recurrence of GC. The recurrence rate of GC in patients who quit smoking is lower than that in patients who do not quit smoking.