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Smoking and intake of heavy alcohol reduces the likelihood of cancer survival among men.

There is previous evidence that these cancer risk factors boost mortality among cancer patients. But no one has investigated how having these risk factors before cancer is diagnosed, influences the survival afterwards.

Researchers from the National Cancer Center in Goyang, South Korea looked at data regarding pre-diagnosis health risk behaviour in 14,578 male cancer patients. They were followed for an average of about nine years after their cancer diagnosis.

Men who had been smokers were at greater risk of dying from any type of cancer than non-smoking cancer patients. There is evidence that smokers are less likely to undergo cancer-screening tests such as colonoscopy, so they may be diagnosed with cancer later on when it is more difficult to treat. Cigarette smoking itself could also make tumours grow more aggressively. Heavy drinkers were more likely to die from head and neck or liver cancer than non-drinkers with either type of cancer, and the risk rose in tandem with the amount of alcohol consumed. Drinking alcohol may increase tumour aggressiveness, or make people less likely to comply with treatment recommendations.

Men who were resistant to the effects of the blood-sugar-processing hormone insulin, which is a warning sign of diabetes, were also more likely to die after a cancer diagnosis. However, the researchers found that people with a high body mass index (a measure of weight in relation to height) were at lower risk of death from cancer overall, and from head and neck or oesophageal cancer specifically. Heavier patients might fare better after cancer diagnoses because they are better nourished and thus more able to survive the rigours of treatment.

The findings suggest that groups at high risk of cancer need to be educated continually to improve their health behaviour - not only to prevent cancer, but also to improve their chances of survival.