吸烟、饮酒与胆道癌关系的全人群病例对照研究

 目的　探讨吸烟、饮酒与胆道癌的关系。方法　采用全人群病例对照研究 ,研究对象为 1997年6月 1日～ 2 0 0 1年 5月 31日期间确诊的、年龄在 35～ 74岁的上海市区 6 2 7例胆道癌新发病例以及按性别、年龄 (5岁一组 )频数配对的 95 9例人群对照。采用非条件logistic回归模型分析吸烟、饮酒与胆道癌的关系。结果　男性中 ,吸烟对肝外胆管癌和壶腹癌各组的调整OR均大于 1,现仍吸烟者的调整OR分别为 1.5 1(95 %CI:0 .86～ 2 .6 6 ) ,1.5 8(95 %CI:0 .6 9～ 3.5 8) ;OR随吸烟年限增加和开始吸烟年龄提早有所升高 ,但均未达显著水平。饮酒对胆道癌各组OR均无统计学意义。结论　吸烟也许与肝外胆管癌、壶腹癌有联系 ,未发现吸烟与胆囊癌的显著性关联 ;未发现饮酒与胆道癌的显著性关联。     

Cigarette smoking and risk of epithelial ovarian cancer (Australia)

Objectives: We studied the association between cigarette smoking and ovarian cancer in a population-based case–control study. Methods: A total of 794 women with histologically confirmed epithelial ovarian cancer who were aged 18–79 years and resident in one of three Australian states were interviewed, together with 855 controls aged 18–79 years selected at random from the electoral roll from the same states. Information was obtained about cigarette smoking and other factors including age, parity, oral contraceptive use, and reproductive factors. We estimated the relative risk of ovarian cancer associated with cigarette smoking, accounting for histologic type, using multivariable logistic regression to adjust for confounding factors. Results: Women who had ever smoked cigarettes were more likely to develop ovarian cancer than women who had never smoked (adjusted odds ratio (OR) = 1.5; 95% confidence interval (CI) = 1.2–1.9). Risk was greater for ovarian cancers of borderline malignancy (OR = 2.4; 95% CI = 1.4–4.1) than for invasive tumors (OR = 1.7; 95% CI = 1.2–2.4) and the histologic subtype most strongly associated overall was the mucinous subtype among both current smokers (OR = 3.2; 95% CI = 1.8–5.7) and past smokers (OR = 2.3; 95% CI = 1.3–3.9). Conclusions: These data extend recent findings and suggest that cigarette smoking is a risk factor for ovarian cancer, especially mucinous and borderline mucinous types. From a public health viewpoint, this is one of the few reports of a potentially avoidable risk factor for ovarian cancer.     

Cigarette smoking, alcohol drinking and the risk of gallbladder cancer death: a prospective cohort study in Japan

Gallbladder cancer is a rare cancer with a poor prognosis, and few risk factors have been identified to date. This prospective study was conducted to evaluate the association of cigarette smoking and alcohol consumption with the risk of gallbladder cancer death. A baseline survey in 45 areas throughout Japan was conducted from 1988 to 1990 using a self-administered questionnaire, and a total of 113,496 participants (65,740 women) aged 40-89 years at entry were followed for 15 years. During the follow-up period, 165 gallbladder cancer deaths (95 women) were observed. Among women, the hazard ratio (HR) [95 percent confidence interval: 95% CI] of current smoker was 2.00 [0.91-4.42], when adjusted for age and drinking. There was no clear association between alcohol consumption and the risk. Among men, HR of current smoker was 2.27 [1.05-4.90]. HRs of those who smoked 21 cigarettes or more per day and those with 801-1,000 cigarette-years were 3.18 [1.18-8.53] and 3.44 [1.40-8.45], respectively, and positive linear associations were observed between that risk and the number of cigarettes per day (p for trend = 0.007) or "cigarette-years" (p for trend = 0.012). The alcohol dose was linearly associated with risk (p for trend = 0.004), where the HR among those who consumed 72.0 g or more of alcohol per day was 3.60 [1.29-9.85]. Among both men and women, cigarette smoking may elevate the risk of death from gallbladder cancer. Drinking may pose an elevated risk among men, but that seems to be less true among women.     

Cigarette smoking,glutathione-s-transferase M1 and t1 genetic polymorphisms,and breast cancer risk (United States)

Objective: It has been suggested that functional polymorphisms in genes encoding tobacco carcinogen-metabolizing enzymes may modify the relationship between tobacco smoking and breast cancer risk. We sought to determine if there is a gene–environment interaction between GSTM1 (GSTM1A and GSTM1B), and GSTT1 genotypes and cigarette smoking in the risk of breast cancer. Methods: Cases and controls were recruited in a case–control study conducted in Connecticut from 1994 to 1998. Cases were histologically confirmed, incident breast cancer patients, and controls were randomly selected from women histologically confirmed to be without breast cancer. A total of 338 cases and 345 controls were genotyped for GSTM1 and GSTT1. Results: None of the GSTM1 genotypes, either alone or in combination with cigarette smoking, was associated with breast cancer risk. There was, however, a significantly increased risk of breast cancer among postmenopausal women with a GSTT1 null genotype (OR = 1.9, 95% CI 1.2–2.9). There were also indications of increased risk of breast cancer associated with cigarette smoking for postmenopausal women with GSTT1-null genotype, especially for those who commenced smoking before age 18 (OR = 2.9, 95% CI 1.0–8.8). Conclusion: Women with a GSTT1-null genotype may have an increased breast cancer risk, especially postmenopausal women who started smoking at younger ages.     

Alcohol Consumption and Risk of Esophageal Cancer in Japan: A Case-control Study in Seven Hospitals

In a multi-center case-control study, we evaluated the riskof esophageal cancer in the Japanese population. All patientsand controls were inpatients in the surgical departments ofseven hospitals nationwide. Patients eligible for the studywere those newly diagnosed as having primary esophageal cancer.One control per case was selected from among patients admittedto the same hospital, and 141 male pairs were analyzed usinglogistic regression analysis. The results showed dose-responserelation between the risk of esophageal cancer and both thequantity (g/week) and frequency (times/week) of alcohol drinking(P value for trend = 0.0001). Altough a statistically significantrisk increase was shown among moderate to heavy smokers (15 cigarette/day < 25) (odds ratio, 4.35:95% confidence interval,1.81-10.49), the dose-response for cigarette smoking was unclear(P value for trend = 0.07). No combined effect of alcohol drinkingand cigarette smoking was found. A frequent intake of fruitwas-associated with a decreased risk (P value for trend = 0.02).After adjustment for alcohol consumption, cigarette smokingand fruit intake were found not to be associated with the risk,whereas a preference for high-temperature food and drink showeda statistically significant positive association (P value fortrend = 0.02). Drinkers who consumed shochu most frequentlyshowed a three-fold increased risk over that for beer consumers,although the association disappeared after adjusting for theamount of alcohol consumed. The present results confirm alcoholintake and a preference for high-temperature food to be associatedwith an increased risk of esophageal cancer and show the amountof alcohol consumed, rather than the type of alcoholic beverage,to be the main risk determinant.     

Alcohol Dehydrogenase 3, Glutathione S-transferase M1 and T1 Polymorphisms, Alcohol Consumption and Hepatocellular Carcinoma (Italy)

Objective: The aim of this study was to investigate the role of alcohol dehydrogenase type 3 (ADH3), glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) polymorphisms in modifying hepatocellular carcinoma (HCC) risk according to alcohol intake.Methods: A hospital-based case–control study was conducted in two areas of North Italy. Two-hundred cases hospitalized for HCC and 400 controls were recruited. Genotypes were determined using PCR and the PCR/restriction fragment length polymorphism-based method.Results: There was no association of the putative risk genotypes ADH3^1-1, GSTM1 null and GSTT1 null with HCC (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.5–1.3; OR, 1.0; 95% CI, 0.6–1.5; OR, 0.8; 95% CI, 0.4–1.4, respectively). A steady increase in HCC risk with increasing alcohol intake, which did not vary according to ADH3 and GSTT1 genotypes, was observed. Nevertheless, the OR for HCC due to an alcohol intake of >100 g of ethanol per day increased in subjects with GSTM1 null genotype (OR, 8.5; 95% CI, 3.9–18.6) compared to GSTM1 non-null genotype (OR, 4.5; 95% CI, 2.0–10.0).Conclusions: ADH3^1-1 and GSTT1 null genotypes did not modify the risk of HCC due to alcohol intake whereas an influence of GSTM1 null genotype for high ethanol consumption was suggested.     

Alcohol Consumption as a Risk Factor for Breast Cancer Development: A Case-Control Study in Brazil

Background: Alcohol consumption is a well-established risk factor for breast cancer, but the evidence is mostlyfrom developed countries. Brazil is going through a rapid demographic expansion, and studies of this relationship arealso needed in such unexplored settings. Methods: We assessed the relationship between alcohol consumption andbreast cancer risk among 1,506 Brazilian women (406 cases and 1,100 controls). Regression models were used tocalculate odds ratios (OR) and 95% confidence intervals (CI). All statistical tests were two-tailed. Results: The meanage of the 1,506 women was 42.0 (standard deviation, ±15.0) years. There was a significant association between breastcancer and age, body mass index, age at menarche, menstrual flow and menstrual cycle. Multivariate analysis showedan increased risk of invasive breast cancer in regular alcohol consumers (years old: OR 3.9; 95% CI 1.2–13.4) compared with abstainers or occasional drinkers. Women with a regular alcoholintake for 10 years or more who were less than 50 years old had a threefold higher risk of developing breast cancer(OR 3.0; 95% CI 1.2–7.6). Conclusion: Regular alcohol consumption increases the risk of breast cancer mainly amongwomen less than 50 years old.     

Cigarette Smoking and Breast Cancer: a Case-control Study in Serbia

Background: Despite the fact that breast cancer is the most common female cancer worldwide, more than halfof the breast cancer risk factors remained unexplained. The aim of this study was to investigate the associationof cigarette smoking with risk of breast cancer. Materials and Methods: A case-control study was conductedin the Clinical Centre of Kragujevac, Serbia, covering 382 participants (191 cases and 191 controls). In theanalysis of data logistic regression was used. Results: Breast cancer risk was significantly increased in thosewho quit smoking at ≤50 years of age (OR=2.72; 95% confidence interval - 95%CI=1.02-7.27) and in those whoquit smoking less than 5 years before diagnosis of the disease (OR=4.36; 95%CI=1.12-16.88). When smokerswere compared with nonsmokers without passive exposure to smoking, former smoking significantly increasedbreast cancer risk (OR=2.37; 95%CI=1.07-5.24). Risk for breast cancer was significantly increased in those whoquit smoking at ≤50 years of age (OR=3.29; 95%CI=1.17-9.27) and in those who quit smoking less than 5 yearsbefore diagnosis of the disease (OR=5.46; 95%CI=1.34-22.28). Conclusions: These data suggest that cigarettesmoking is associated with an elevated risk of breast cancer among former smokers in Serbia.     

A Case-Control Study of Stomach Cancer and Its Genesis in Relation to Alcohol Consumption, Smoking, and Familial Cancer History

A case-control study of stomach cancer and its genesis has been conducted in relation to alcohol consumption, cigarette smoking, and familial cancer history. Two hundred and ninety-four cancer cases, discovered by mass screening and histologically verified after endoscopic examination, have been compared with 588 randomly selected controls, who received the same early detection program and were verified as being free of the disease. No statistically significant association was observed between the development of stomach cancer and alcohol consumption or familial cancer history. However, the development of stomach cancer was found to have a positive correlation with smoking (relative risk for those who smoke less than 19 cigarettes/day, 3.56: 95% confidence interval, 2.39 to 5.31; relative risk for those who smoke more than 20 cigarettes/day, 2.58: 95% confidence interval, 1.60 to 4.17). The results of this study suggest that cigarette smoking appears to have a more harmful effect on the development of stomach cancer than either alcohol consumption or a familial history of cancer. The high relative risk of smoking revealed by this study implies that further research on the effects of smoking in the development of stomach cancer would be desirable.     

Cigarette smoking, alcohol consumption and risk of nasopharyngeal carcinoma in Taiwan

Objectives: Nasopharyngeal carcinoma (NPC) is rare in most countries but occurs with relatively high frequency among southern Chinese populations throughout the world. A case-control study of NPC was conducted in Taiwan to investigate the importance of active and passive cigarette exposure and alcohol consumption as risk factors for this disease.Methods: 375 histologically confirmed incident NPC cases (99% response rate) were prospectively identified from two hospitals in Taipei between July 1991 and December 1994 and administered a detailed questionnaire. 327 healthy community controls individually matched to cases on sex, age and residence were selected (88% response rate).Results: After multivariate adjustment, the odds ratio (OR) and 95% confidence interval (CI) was 1.7 (1.1–2.9 with p = 0.03 for increasing dose-response) for those who smoked for 25 years compared with non-smokers. Passive smoking during childhood or adult life was not associated with an increased risk of disease. Alcohol consumption was not associated with NPC risk. The OR for subjects with 15 grams of ethanol per day compared to non-drinkers was 1.1 (95% CI = 0.7–1.7).Conclusions: Our results suggest that long term cigarette smoking is associated with NPC but that low level exposure to cigarette smoke via passive exposure and alcohol consumption are not associated with disease risk.     

Cigarette smoking and breast cancer risk: a population-based study in Sweden

In a Swedish population-based case-control study, smoking showed no convincing association with risk of postmenopausal breast cancer - regardless of timing or level of smoking exposure - either overall or among subgroups.     

Active and Passive Smoking,and Alcohol Drinking and BreastCancer Risk in Chinese Women

To evaluate the relation between smoking, alcohol drinking and risk of breast cancer in Chinese women, weconducted a case-control study with 669 cases and 682 population-based controls in Jiangsu Province of China.A structured questionnaire was used to elicit detailed information. Unconditional logistic regression analysis wasperformed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The results revealed that smoking,whether active or passive through the husband, was related to increased risk of breast cancer. The ORs (adjustedfor age, menopausal status, educational levels, occupation, body mass index and income) were 3.55 (95%CI:1.27-9.91) for active smoking and 1.47 (95%CI: 1.18-1.84) for passive smoking from husbands, respectively. Asignificant positive relationship was observed between breast cancer risk and the degree of husbands’ smoking.There were significant increase trend in ORs with the daily smoked number of cigarettes of husbands, thepassive smoking years from husbands and the pack-years of husbands’ smoking (trend test: p=0.00003, 0.00013and 0.0001, respectively). Alcohol consumption was also found to be a risk factor. The findings of this study inparticular suggest that husbands’ smoking increases risk of breast cancer in Chinese women.     

Cigarette Smoking and Prostate Cancer Risk: Negative Results of the Seoul Male Cancer Cohort Study

We evaluated cigarette smoking as a risk factor for prostate cancer in a prospective, population-based cohortstudy. The subjects were 14,450 males among the participants in the Seoul Male Cancer Cohort Study who hadat least 1-year follow-up. They were followed up between 1993 and 2008. During the 16-year follow-up period,87 cases of prostate cancer occurred over the 207,326 person-years of the study. The age-adjusted relative risksof past and current smokers at entry were 0.60 (95%CI: 0.34-1.06) and 0.70 (95%CI: 0.43-1.13), respectively,suggesting that cigarette smoking may not be a risk factor for prostate cancer. The relationship between prostatecancer and other modifiable factors, such as Westernized diet, should be studied with the goal of establishingprevention programs for prostate cancer.     

Vegetables, Fruit Consumption and Risk of Lung Cancer among Middle-Aged Japanese Men and Women: JPHC Study

OBJECTIVE: To investigate the association between vegetable and fruit consumption and incidence of lung cancer. METHODS: Self-administered questionnaires were used to assess diet in two large population-based cohorts with 42,224 and 51,114 subjects in 1990 and 1993, respectively. After ten and seven years of follow-up, we ascertained 428 newly diagnosed case of lung cancer. Relative risk (RR) estimates were calculated using the Cox proportional hazards model with pooling of estimates from the two cohorts. RESULTS: Total vegetable and fruit intake was not associated with lowered risk of lung cancer, with RR approximating unity. The null relation between vegetable and fruit consumption and lung cancer incidence was consistent across strata of smoking status (never or ever smokers). When dividing lung cancers into adenocarcinoma and non-adenocarcinoma, risk for middle and high intakes of vegetables only, fruit only, and vegetables and fruit combined were all below one for non-adenocarcinoma and above one for adenocarcinoma, although no statistically significant differences were noted. Similar patterns of results were found when the two cohorts were analyzed separately. CONCLUSIONS: Contrary to popular belief, our results suggest that vegetables and fruit do not appear to confer protection from lung cancer.     

Green tea drinking,high tea temperature and esophageal cancer in high‐ and low‐risk areas of Jiangsu Province,China: A population‐based case–control study

Epidemiological studies suggested drinking green tea is inversely associated with esophageal cancer but results remain inconclusive. Moreover, inconsistent observations found high temperature drinks are associated with esophageal cancer. A population‐based case–control study was conducted in a high‐risk area (Dafeng) and a low‐risk area (Ganyu) of esophageal cancer in Jiangsu province China from 2003 to 2007. It aimed to explore green tea drinking and tea temperature with the risk of esophageal cancer, and to compare the difference between different risk regions. Using identical protocols, 1,520 cases and 3,879 healthy controls were recruited as study subjects in 2 regions. Detailed information was collected to assess green tea drinking habits. Unconditional logistic regression was used to obtain OR and 95% CI. Results showed that ever drinking green tea elevated OR in both counties (Dafeng OR = 1.2, 95% CI = 0.9–1.5; Ganyu: OR = 1.9, 95% CI = 1.4–2.4). Drinking tea at high temperature was found to increase cancer risk in both areas (Dafeng: OR = 1.9, 95% CI = 1.2–2.9; Ganyu OR = 3.1 95% CI = 2.2–4.3). However, after further adjustment for tea temperature, ever drinking tea was not related to cancer in either county (Dafeng: OR = 1.0, 95% CI = 0.7–1.3; Ganyu: OR = 1.3, 95% CI = 0.9–1.7). For dose‐response relationships, we observed positive relationship with monthly consumption of tea (p for trend = 0.067) and tea concentration (p for trend = 0.006) after further adjustment for tea temperature. In conclusion, green tea drinking was not inversely associated with esophageal cancer in this study. However, drinking tea at high temperatures significantly increased esophageal cancer risk. There was no obvious difference of green tea drinking between low‐ and high‐risk areas. © 2008 Wiley‐Liss, Inc.     

Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study

We investigated the risk of gastric cancer by subsite in relation to cigarette smoking and alcohol in a large population-based cohort of 669 570 Korean men in an insurance plan followed for an average 6.5 years, yielding 3452 new cases of gastric cancer, of which 127 were cardia and upper-third gastric cancer, 2409 were distal gastric cancer and 1007 were unclassified. A moderate association was found between smoking, cardia and upper-third (adjusted relative risk (aRR) 2.2; 95% confidence interval (CI) 1.4-3.5) and distal cancers (aRR=1.4; 95% CI=1.3-1.6). We also found a positive association between alcohol consumption and distal (aRR=1.3; 95% CI=1.2-1.5) and total (aRR=1.2; 95% CI=1.1-1.4) gastric cancer. Combined exposure to high levels of tobacco and alcohol increased the risk estimates further; cardia and upper-third gastric cancers were more strongly related to smoking status than distal gastric cancer.British Journal of Cancer (2007) 97, 700-704. doi:10.1038/sj.bjc.6603893 www.bjcancer.com Published online 17 July 2007.     

Cigarette smoking,alcohol consumption and subsequent gastric cancer risk by subsite and histologic type

The effect of cigarette smoking or alcohol consumption on the risk of gastric cancer has not been clarified. We investigated this relationship, considering the anatomic subsite and histologic type of gastric cancer. A total of 19,657 men (aged 40-59 years at baseline), who responded to the baseline questionnaire and reported no serious illness at that time, were followed for 10 years, from January 1990 to December 1999. Gastric cancer was confirmed histologically in 293 men. Smoking was associated with an increased risk of the differentiated type of distal gastric cancer; compared to the group who never smoked, the adjusted rate ratios (RRs) of gastric cancer for past and current smokers were 2.0 (95% CI 1.1-3.7) and 2.1 (95% CI 1.2-3.6), respectively. No association was observed between cigarette smoking and risk of the undifferentiated type of distal gastric cancer except for a suggestive association with cardia cancer. For alcohol consumption, elevated risk was suggested only for cardia cancer of all histologic types, though the relationship failed to reach significance. Among those who drank alcohol at least once per week, RRs for ethanol intake of 2.7-161.0, 162.0-322.0 and 322.5+ g/week compared to those who drank 0-3 times/month were 2.5 (95% CI 0.7-9.5), 3.3 (0.9-11.6) and 3.0 (0.8-11.1), respectively (p(trend) = 0.66). In conclusion, our results confirm that smoking is related to gastric cancer of the differentiated type. Further studies with more cases are needed to detect a positive association between cigarette smoking or alcohol consumption and cardia cancer.     

Menopausal hormone therapy use and breast cancer risk in Australia: Findings from the New South Wales Cancer,Lifestyle and Evaluation of Risk study

Randomised controlled trials and large‐scale observational studies have found that current use of menopausal hormone therapy (MHT) is associated with an increased risk of breast cancer; this risk is higher for oestrogen–progestagen combination therapy than for oestrogen‐only therapy. Our study was designed to estimate MHT‐associated breast cancer risk in a population of Australian women. Data were analysed for postmenopausal women with self‐reported incident invasive breast cancer (n = 1,236) and cancer‐free controls (n = 862), recruited between 2006 and 2014 into a large case–control study for all cancer types, the NSW CLEAR study. Information on past and current MHT use was collected from all participants, along with other lifestyle and demographic factors, using a self‐administered questionnaire. Unmatched multivariable logistic regression was performed, adjusting for socio‐demographic, reproductive and health behaviour variables, body mass index and breast screening history. Compared to never users of MHT, the adjusted odds ratio (aOR) for breast cancer in current users of any type of MHT was 2.09 (95% CI: 1.57–2.78; p < 0.0001) and for past users of any type of MHT was 1.03 (0.82–1.28; p = 0.8243). For current users of oestrogen‐only and oestrogen–progestagen therapy, aORs were 1.80 (1.21–2.68; p = 0.0039) and 2.62 (1.56–4.38; p = 0.0003), respectively. These findings are consistent with those from other international observational studies, that current, but not past, use of MHT is associated with a substantially increased risk of breast cancer.     

非小细胞肺癌FHIT蛋白表达与吸烟关系的研究

[目的]探讨非小细胞肺癌中FHIT蛋白表达与吸烟的关系。[方法]采用SP免疫组化法检测77例非小细胞肺癌组织和25例非恶性肿瘤肺组织中FHIT蛋白的表达。[结果]病例组FHIT蛋白表达缺失率显著高于对照组（63.64%vs20.00%,χ^2=14.42,P=0.001)，病例组中吸烟患者FHIT蛋白表达阴性率显著高于不吸烟患者（70.97%vs 33.33%,χ^2=7.39,P=0.007)。[结论]FHIT可能是烟草致癌物的作用靶点。     

GSTM1 and GSTT1 Polymorphisms, Cigarette Smoking, and Risk of Colon Cancer: A Population-based Case-control Study in North Carolina (United States)

Cigarette smoke is a risk factor for colon cancer, but the importance of dose and interaction with genetic susceptibility remain poorly understood. We used data from a population-based case control study, to examine the association between cigarette smoking and colon cancer in African Americans and whites, and colon cancer and polymorphisms in GSTM1 and GSTT1. A total of 554 cases of primary colon cancer and 874 controls were included in this analysis. We found no association between cigarette smoking (ever versus never) and colon cancer in African Americans (odds ratio (OR)=0.93, 95% confidence interval (CI)=0.65–1.33). In contrast, there was an increased risk of cigarette smoking in whites (OR=1.43, CI=1.05–1.94). There was a small increased risk of colon cancer for individuals with GSTM1 null (African Americans, OR=1.43, CI, 0.98–2.09; whites, OR=1.19, CI, 0.90–1.58) and a decreased risk of colon cancer for individuals with GSTT1 null (African Americans, OR=0.59, CI: 0.40–0.86; whites, OR=0.72, CI: 0.53–1.00). There were weak interactions between GSTT1 null and cigarette smoking in whites, and GSTM1 null genotype and cigarette smoking in African Americans. GSTT1 and GSTM1 polymorphisms may be weakly related to colon cancer risk and there may be racial differences in gene-smoking interactions.