Cigarette,cigar and pipe smoking,passive smoke exposure,and risk of pancreatic cancer: a population-based study in the San Francisco Bay Area

Background  

To examine the influence of cigarette, cigar and pipe smoking, cessation of cigarette smoking and passive smoke exposure on the risk of pancreatic cancer.     

Ethnic differences in the lung cancer risk associated with smoking.

Mortality trends and ecological data strongly suggest that the lung cancer risk associated with smoking is greater among Hawaiians than among the other ethnic groups in Hawaii. The authors combined data from two consecutive population-based case-control studies to formally test this hypothesis among 740 cases and 1616 controls. A multiple logistic regression analysis adjusting for pack-years of smoking, occupation, education, and age revealed that Hawaiian, Filipino, and Caucasian male smokers were at 121%, 53%, and 46% greater risk for lung cancer than Japanese male smokers. These risk differences were statistically significant, were consistent across sexes and histological types, and were not explained by the type of cigarettes, the level of inhalation, or by cholesterol or beta-carotene intake. Additionally, an increased lung cancer risk unrelated to smoking was observed among Chinese women. The possibility that other dietary antioxidants and/or genetic risk factors are responsible for these ethnic differences needs to be investigated.     

Lung bullae and pulmonary fibrosis associated with marijuana smoking

A 26‐year‐old man with a history of heavy marijuana and minimal tobacco use was found to have extensive bilateral lung bullae and interstitial fibrosis, heavily infiltrated by pigmented macrophages. These features can be associated with marijuana smoking. The differential diagnoses in this patient are also discussed.     

Cigar, pipe, and cigarette smoking and bladder cancer risk in European men

Objective: Estimating the risk of bladder cancer from cigar and pipe smoking is complicated by a small number of non-cigarette smokers included in most relevant studies. Methods: We undertook a pooled analysis of the data on men from six published case–control studies from Denmark, France, Germany, and Spain, to assess the association between pipe and cigar smoking and bladder cancer, and to compare it with the risk from cigarette smoking. Complete history of tobacco smoking was ascertained separately for cigarettes, cigars, and pipe. Odds ratios (ORs) were estimated after adjusting for age, study, and employment in high-risk occupations. Results: The pooled data set comprised 2279 cases and 5268 controls, of whom 88 cases and 253 controls smoked only cigars or pipe. The OR for pure cigarette smoking was 3.5 (95% confidence interval [CI] 2.9–4.2), that for pure pipe smoking was 1.9 (95% CI 1.2–3.1) and that for pure cigar smoking was 2.3 (95% CI 1.6–3.5). The increase in the OR of bladder cancer that was observed with duration of smoking was non-significantly lower for cigars than for cigarettes. Conclusion: Our results suggest that smoking of cigars and pipe is carcinogenic to the urinary bladder, although the potency might be lower than for cigarettes.     

Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe

BACKGROUND: Because limited information is available on the quantitative association between consumption of tobacco products other than cigarettes and lung cancer risk, we undertook a case-control study of this relationship. METHODS: We investigated lung cancer risk among smokers of cigars and/or cigarillos only and of pipes only and compared these risks with the risk of smokers of cigarettes only in a case-control study conducted in seven European areas. Our study population consisted of 5621 male case patients with lung cancer and 7255 male control subjects. Each subject or his proxy was interviewed with respect to the subject's smoking history and other risk factors for lung cancer. RESULTS: The odds ratio (OR) for smoking cigars and cigarillos only was 9.0 (95% confidence interval [CI] = 5.8-14.1), based on 43 exposed case patients and 77 exposed control subjects, and the OR for smoking a pipe only was 7.9 (95% CI = 5.3-11.8), representing 61 case patients and 129 control subjects. The OR for smoking cigarettes only was 14.9 (95% CI = 12.3-18.1), based on 4204 case patients and 3930 control subjects. A dose-response relationship was present for duration of use and cumulative consumption both for cigars and cigarillos and for pipe tobacco. An effect was also suggested for inhalation of cigar and cigarillo smoke. The dose-response relationships between lung cancer risk and either duration of smoking or average and cumulative consumption were similar for cigar and cigarillo smoking, pipe smoking, and cigarette smoking. CONCLUSION: Our results suggest that smoking of European cigars, cigarillos, and pipe tobacco might exert a carcinogenic effect on the lung comparable to that of cigarettes.     

Lung cancer and smoking in Danish women

In most developed countries, including Denmark, cancer of the lung is the most frequent malignant disease among men, whereas the problem is less among women. Examination of Danish mortality data for the period 1931 to 1972 reveals a 5-fold increase in female rates as opposed to a 16-fold increase in male rates. Since about 1960 female rates have, however, increased faster than male rates with a consequent decline in the male-female ratio. It is demonstrated that more recent female birth-cohorts have higher mortality rates than the older ones. The increasing mortality from lung cancer among more recent female cohorts is shown to parallel increasing proportions of smokers in these cohorts. Further data are presented to indicate that not only is smoking more widespread among young than among old women, but the proportion of cigarette smokers among all smokers falls from 98% in the youngest to 33% in the oldest age-group. No causal relationship between smoking and lung cancer can be claimed from the evidence presented. The present findings are, however, what would be expected if cigarette-smoking were an aetiological factor in female lung cancer.     

Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium

To investigate the association between cannabis smoking and lung cancer risk, data on 2,159 lung cancer cases and 2,985 controls were pooled from 6 case‐control studies in the US, Canada, UK, and New Zealand within the International Lung Cancer Consortium. Study‐specific associations between cannabis smoking and lung cancer were estimated using unconditional logistic regression adjusting for sociodemographic factors, tobacco smoking status and pack‐years; odds‐ratio estimates were pooled using random effects models. Subgroup analyses were done for sex, histology and tobacco smoking status. The shapes of dose‐response associations were examined using restricted cubic spline regression. The overall pooled OR for habitual versus nonhabitual or never users was 0.96 (95% CI: 0.66–1.38). Compared to nonhabitual or never users, the summary OR was 0.88 (95%CI: 0.63–1.24) for individuals who smoked 1 or more joint‐equivalents of cannabis per day and 0.94 (95%CI: 0.67–1.32) for those consumed at least 10 joint‐years. For adenocarcinoma cases the ORs were 1.73 (95%CI: 0.75–4.00) and 1.74 (95%CI: 0.85–3.55), respectively. However, no association was found for the squamous cell carcinoma based on small numbers. Weak associations between cannabis smoking and lung cancer were observed in never tobacco smokers. Spline modeling indicated a weak positive monotonic association between cumulative cannabis use and lung cancer, but precision was low at high exposure levels. Results from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long‐term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded.     

Sex differences in lung-cancer risk associated with cigarette smoking

The importance of cigarette smoking as a risk factor for specific histologic types of lung cancer in men and women has been examined in a case-control analysis of data from the Cancer Surveillance Program of Orange County, a population-based registry. Smoking habits were abstracted from medical records for 1153 men and 833 women diagnosed with primary lung cancer in 1984–1986 and 1851 men and 1656 women aged 30 or older diagnosed with cancers not associated with smoking. Ninety-six percent of men and 89% of women with lung cancer were current or former cigarette smokers, as compared with 55% of men and 34% of women with other cancers. The age and ethnicity-adjusted odds ratios (OR) for ever-smoking were 19.7 for men and 15.0 for women. Men and women who smoked 2 or more packs per day experienced nearly equal risks. Comparison of the most common cell types showed that women smokers had equal or lower ORs for squamous-cell carcinoma and adenocarcinoma, but higher OR for small-cell carcinoma, as compared with men smokers. While the smoking-associated OR were equal for small-cell and squamous-cell carcinomas in men, the OR for women were significantly higher for small-cell carcinoma than for squamous-cell carcinoma.     

Lung cancer risk associated with Thr495Pro polymorphism of GHR in Chinese population

The incidence of lung cancer has been increasing over recentdecades. Previous studies showed that polymorphisms of the genesinvolved in carcinogen-detoxication, DNA repair and cell cyclecontrol comprise risk factors for lung cancer. Recent observationsrevealed that the growth hormone receptor (GHR) might play importantroles in carcinogenesis and Rudd et al. found that the Thr495Propolymorphism of GHR was strongly associated with lung cancerrisk in Caucasians living in the UK (OR = 12.98, P = 0.0019,95% CI: 1.77–). To test whether this variant of GHR wouldmodify the risk of lung cancer in Chinese population, we comparedthe polymorphism between 778 lung cancer patients and 781 healthycontrol subjects. Our results indicate that the frequency of495Thr (2.8%) allele in cases was significantly higher thanin controls (OR = 2.04, P = 0.006, 95% CI: 1.21–3.42)which indicated this allele might be a risk factor for lungcancer. Further analyses revealed Thr495Pro variant was associatedwith lung cancer in the subpopulation with higher risk for lungcancer: male subpopulation, still-smokers subpopulation andthe subpopulation with familial history of cancer. In differenthistological types of lung cancer, Thr495Pro SNP was significantlyassociated with small cell and squamous cell lung cancer, butnot with adenocarcinoma, which suggested a potential interactionbetween this polymorphism and metabolic pathways related tosmoking. The potential gene–environment interaction onlung cancer risk was evaluated using MDR software. A significantredundant interaction between Thr495Pro polymorphism and smokingdose and familial history of cancer was identified and the combinationof genetic factors and smoking status or familial history ofcancer barely increased the cancer risk prediction accuracy.In conclusion, our results suggested that the Thr495Pro polymorphismof GHR was associated with the risk of lung cancer in a redundantinteraction with smoking and familial history of cancer.     

Lung cancer in Greater Bombay: correlations with religion and smoking habits

The resident population of Greater Bombay was analysed for the incidence of lung cancer and other variables of possible significance to lung cancer incidence. During a 10-year period from 1964-73, 2177 lung cancer cases (1861 males, 316 females) were registered, from a population pool consisting of 5.24 million persons (3.07 million males, 2.17 million females). The average annual incidence of lung cancer was 13.6 per 10(5) males but only 3.3 per 10(5) females, age-adjusted to the Standard World Population. The incidence in non-Parsi males (14.0) was almost double the figure in Parsi males (6.8). There was however no significant difference in incidence between non-Parsi (3.8) and Parsi females (3.3). Time-trend analyses did not reveal statistically significant differences in the incidence of lung cancer in any particular (male or female) age group. The data from death certificates for the same 10-year period 1964-73, showed that the age-adjusted rates (standardized to the world population) were 11.0 and 3.3 per 10(5), for males and females, in the total population. In a retrospective study, 792 males with lung cancer (42.6% of 1861 male cancer patients) for whom detailed smoking history is available, were matched for age and community with randomly selected controls, obtained from the voters list of the Greater Bombay Corporation, and significant statistical association was found between tobacco smoking and lung cancer. All smokers appear to be at high risk (16.8) compared with non-smokers. The relative risk in bidi smokers was however 19.3, even higher than in cigarette smokers (896). Hindu, Muslim and Christian smokers are apparently at identical risks. A dose-reponse relationship was found in bidi and cigarette smokers.