Lung cancer in women in the Niagara Region, Ontario: a case-control study.

A case-control study of the etiology of lung cancer in women was conducted in the Niagara Region of Ontario, because of local concerns about a high incidence of lung cancer. 51 female patients with lung cancer and 45 matched controls were interviewed. Information was collected about active and passive smoking, occupation and residential history. There was a strong association between active cigarette smoking and lung cancer (ever/never odds ratio 10.0; p less than .001) and 85% of the cases of lung cancer were attributed to active cigarette smoking. No other factors were significantly associated with lung cancer; there was weak evidence of an association between urban environment during childhood and lung cancer (p = 0.07). Associations between lung cancer and air pollution, and residential history, were not demonstrated, contrary to public perception. Thus, a previously reported excess of lung cancer in Niagara females is most likely attributable to cigarette smoking.     

Retrospective cohort study of smoking and lung cancer incidence in rural prefecture,Japan

Objectives We conducted an epidemiological study of the relationship between lung cancer incidence and smoking, with special reference to the benefits of smoking cessation for reducing lung cancer incidence, to promote a local smoking control program. Methods The study was a retrospective cohort study. The population studied was 16,383 male examinees of lung cancer health examinations in 1995 in Tottori Prefecture, Japan. Smoking status from the questionnaire during the health examination was used as the exposure variable. Endpoint (lung cancer incidence) was obtained from the Tottori population-based cancer registry. A multivariable analysis using the Cox proportional hazard model was adapted for statistical analysis. The average follow-up period was 4.3 years. Results The hazard ratio of current smokers for the incidence of lung cancer was 4.9, whereas that of ex-smokers was 2.2. The dose-response relationship between lung cancer incidence and lifetime cigarette consumption (pack year) was determined. The ratio increased among younger subjects (under 65 years old). The hazard ratio of ex-smokers decreased with years just after quitting smoking, and reached the level of never smokers after 10–19 years from smoking cessation. Conclusions We reconfirmed that the magnitude of risk estimates of smoking for lung cancer incidence was similar to those of previous studies, and smoking cessation was effective for reducing lung cancer risk.     

吸烟在云锡矿工肺癌发病中的作用

本文以1975-1984年为时段,对云南锡业公司所属六个单位工人进行了吸烟情况的调查分析。结果表明,吸烟者的肺癌发病率是非吸烟者的3.65倍。吸烟者的SMR为29.41;非吸烟者为8.42。无论吸烟程度如何,其发病、死亡都是有井下史者高于无井下史者。吸烟与职业性因素的复合作用是:吸烟+井下>单纯井下>单纯吸烟>非吸烟无井下史者。     

Use of a multistage model to predict time trends in smoking induced lung cancer.

STUDY OBJECTIVE--The aims were to use a mathematical model to predict the time course of smoking induced lung cancer, and to investigate to what extent the most recent increases in lung cancer mortality are due to cigarette smoking. DESIGN--A mathematical model was developed and solved by simulation to construct detailed smoking histories of the US white male population given available prevalence data by age and cohort. A multistage carcinogenesis model was used to predict the time course of smoking induced lung cancer given the detailed smoking histories. SOURCE OF DATA AND MODEL PARAMETERS--The smoking prevalence figures were taken from work by Harris who calculated them using data collected in the Health Interview Survey. The parameters of the multistage model were taken from Whittemore who fitted the model to several sets of smoking and lung cancer data. MAIN RESULTS--The smoking model was used to construct detailed smoking histories of the US white male population from 1900 to 1985. In turn the multistage model was used to predict age and cohort specific smoking induced lung cancer mortality rates over this period. These results were compiled to predict the overall age adjusted trend in smoking induced lung cancer from 1970 to 1985. The model predicts a 12% decline in smoking induced lung cancer for this group over the 15 year period. CONCLUSIONS--The model calculations predict a 12% decline in smoking induced lung cancer for this group, during a period when the actual total rate of lung cancer increased by 26%. Taken together with the decline in average tar content in cigarettes over this period, and the relatively constant dose rate among smokers, these results strongly suggest that the recent increase in lung cancer among white males in the USA is due entirely or in large part to factors other than cigarette smoking.     

ABO血型及其和吸烟的交互作用与肺癌易感性

目的：探讨ABO血型及其与吸烟交互作用与肺癌的相关性。方法：肺癌病例143例,年龄、性别匹配的对照121例;血清学方法检测血型,面访或查阅病历调查,分层分析血型与吸烟的交互作用。结果：单B型血者与肺癌无显著性联系,单吸烟者则联系显著,OR值2．09,同时具有B型血并吸烟,则联系非常显著,其OR值达5．88。结论B型血是肺癌的可能是易感标志,并与吸烟具有协同作用。     

肺癌筛查与吸烟行为改变的关联研究

1 314名四川省肺癌筛查及早诊早治项目地区肺癌高危人群的戒烟率从基线时的22.37%增至筛查后的41.78%(χ²=227.97,P<0.001),持续吸烟者的吸烟量从20支/d降至15支/d(t=11.76,P<0.001);肺癌筛查中出现阳性结果者更倾向于戒烟或持续保持戒烟状态,男性、年龄较小、教育程度较低将增加持续吸烟或复吸的风险(P<0.05)。     

The joint effect of smoking and respiratory symptoms on risk of lung cancer

In 1962 a cohort of 4604 Finnish men were interviewed about their smoking habits and cardiorespiratory symptoms. The cohort was followed up for deaths and incidence of lung cancer from 1963 to 1980 in order to study the effect of smoking and respiratory symptoms on the risk of lung cancer. The joint effect of smoking, age and respiratory symptoms on the risk of lung cancer was studied using a log-linear modelling technique. When analysed simultaneously with smoking, the symptoms of phlegm, shortness of breath and wheezing were all significantly associated with increased lung cancer risk. The joint effect of smoking and phlegm as well as that of smoking and wheezing was close to being multiplicative. Even if smoking is a causative factor in both these symptoms and in lung cancer, the symptoms seem to have a separate role as predictors of lung cancer risk.     

The Association Between Cancer Risk and Age at Onset of Smoking in Japanese

Background

Young age at onset of smoking is a known risk factor for cancer; however, few studies have investigated the risk of cancer associated with onset of smoking during adolescence in Japan.

Methods

We analyzed a portion of the data from a population-based cohort of 40 897 subjects aged 40 to 69 years with a history of smoking and no history of cancer at baseline.

Results

During a 14-year follow-up period, 4386 total cancers and 681 lung cancers were newly diagnosed. As compared with smokers who started smoking after the age of 20 years, those who started before the age of 17 years smoked a significantly larger number of cigarettes per day for a significantly longer duration; they also had a significantly higher risk of lung cancer. The hazard ratios in men and women were 1.48 (95% confidence interval, 1.11–1.96) and 8.07 (2.34–27.85), respectively. After further adjustment for smoking amount, the associations remained significant. There was a statistically significant inverse correlation between lung cancer risk and age at onset of smoking in male current smokers whose baseline age was 50 to 59 years; no such association was detected among other age strata.

Conclusions

There was no clear evidence of increased risk of cancer due to adolescent smoking. However, adolescent smoking appeared to indirectly increase lung cancer risk because it was associated with a longer duration and larger amount of smoking.Key words: cancer, lung cancer, cigarette smoking, age, incidence     

肺癌危险因素及交互作用研究

目的探讨肺癌的影响因素及其交互作用。方法采用病例对照研究设计,收集781例肺癌病例,并按性别、年龄(±3岁)进行1:1匹配,通过调查问卷获取生活饮食习惯等信息。构建决策树及非条件Logistic回归模型,计算OR值及其95%CI,分析影响因素间的交互作用。结果肺癌的危险因素有吸烟(轻度吸烟OR=1.67,重度吸烟OR=7.27)、被动吸烟(轻度被动吸烟OR=2.63,重度被动吸烟OR=6.25)、居住地污染(吸烟者OR=2.26,不吸烟者OR=1.72)、肺癌家族史(吸烟者OR=15.94);保护因素有常吃水果(吸烟者OR=0.69,不吸烟者OR=0.44)、锻炼(吸烟者OR=0.50)、饮茶(不吸烟者OR=0.57)。吸烟与居住地污染、肺癌家族史存在交互作用,重度吸烟与不锻炼存在交互作用。结论吸烟、被动吸烟、居住地污染、肺癌家族史可增加肺癌风险,常吃水果、锻炼、饮茶有助于预防肺癌。肺癌影响因素间的协同作用应予重视。     

Fruit and VegeTable Intake and Lung Cancer Incidence Among Black Women According to Cigarette Smoking Status

This project evaluated associations between fruit and vegetable intake, cigarette smoking and lung cancer incidence among U.S. Black women. The Black Women’s Health Study is a prospective cohort study (analytic cohort?=?46,889) among Black women between the ages 21 and 69 at baseline (1995). Fruit and vegetable intake and smoking history were ascertained via questionnaires at baseline and during follow-up. Associations between fruit and vegetable intake, smoking and lung cancer incidence (N?=?306 incident cases through 2013) were evaluated using Cox proportional hazards regression. Among women in this cohort, 6.1% and 5.6% reported consuming at least three servings/d of fruit or vegetables, respectively. Smoking history was associated with increased lung cancer incidence. Being a current smoker of ≥15 cigarettes/d was associated with higher lung cancer incidence compared to never smokers (HR?=?17.4, 95% CI: 11.5, 26.4). Fruit and vegetable was not associated with lung cancer incidence intake (≥5 vs. <3 servings/d, adjusted HR: 0.86, 95% CI: 0.54, 1.36). Associations between fruit and vegetable intake and lung cancer incidence did not differ by smoking history. Fruit and vegetable intake was low in this study population, but results do not support an association between fruit and vegetable intake and lung cancer incidence, regardless of smoking history.     

Peer Reviewed: Family History of Lung Cancer and Contemplation of Smoking Cessation

Introduction

The prevalence of cigarette smoking in the United States has decreased, but current rates remain above nationally set objectives. A family history of lung cancer may motivate adult smokers to quit and contribute to further reductions in smoking prevalence.

Methods

We surveyed adult smokers (N = 838) interviewed as part of the 2005 Health Information National Trends Survey. We examined the association between family history of lung cancer and smoking cessation precontemplation (not considering), contemplation (considering), and preparation.

Results

More people who reported a family history of lung cancer were in contemplation/preparation stages (41%) than were in the precontemplation stage (19%). Adults who reported a family history of lung cancer were more likely (odds ratio 2.55 [95% confidence interval, 1.44-4.52]) to be contemplators than precontemplators after adjusting for demographic variables and level of daily smoking.

Conclusion

Family history of lung cancer among adult smokers may be associated with contemplating quitting smoking. Further investigation of family history''s role in bolstering motivation to quit smoking may assist in developing or improving smoking cessation interventions for this group.     

Menthol cigarettes and risk of lung cancer

The authors analyzed data from a multihospital case-control study in the eastern United States to evaluate the hypothesis that smoking menthol cigarettes increases lung cancer risk compared with smoking nonmenthol cigarettes. Subjects included cases with lung cancer and controls admitted for conditions unrelated to smoking who were aged 40-74 years, were interviewed from 1981 to 2000, and had smoked for >or=20 years. Information was available on the brand and type of cigarette smoked most recently and for the longest time. Analyses were based on 643 cases and 4,110 controls for whom brand information was available for >or=60% of the total duration of smoking. Logistic regression was used to estimate the relative risk of lung cancer according to number of years of menthol cigarette use (>15, 1-15, 0), adjusting for demographic and smoking-related factors. The lung cancer risk for long-term smokers of menthol cigarettes was similar to that for smokers of nonmenthol cigarettes (odds ratio = 0.97, 95% confidence interval: 0.70, 1.34). Odds ratios were also close to 1.0 in separate analyses of male, female, Black, and White subjects. The results of this study do not support the hypothesis that smoking menthol cigarettes increases the risk of lung cancer relative to smoking nonmenthol cigarettes.     

Does smoking influence the physical activity and lung cancer relation? A systematic review and meta-analysis

Research suggests an inverse association between physical activity and lung cancer. However, whether the relation is modified by degree of smoking adjustment has not been summarized. We conducted a meta-analysis of physical activity and lung cancer focusing on evaluating whether smoking status and the degree of smoking adjustment influenced the association. Comparing high versus low physical activity levels from 25 observational studies yielded a lung cancer summary relative risk (RR) of 0.79 [95 % confidence interval (CI) = 0.72–0.87], with RRs of 0.87 (95 % CI = 0.80–0.94) for cohort studies and 0.57 (95 % CI = 0.46–0.71) for case–control studies. In further analyses restricted to cohort studies, physical activity was inversely related to lung cancer among former smokers (RR = 0.68, 95 % CI = 0.51–0.90) and current smokers (RR = 0.80, 95 % CI = 0.70–0.90), whereas the association was null among never smokers (RR = 1.05, 95 % CI = 0.78–1.40, p interaction = 0.26). The degree of smoking adjustment did not modify the association (p interaction = 0.73). Physical activity was unrelated to lung cancer among never smokers but it was inversely associated with lung cancer among former and current smokers. Although the physical activity and lung cancer relation was not modified by smoking status or degree of smoking adjustment, residual confounding by smoking remains a possible explanation for the relations observed.     

Toenail nicotine level as a novel biomarker for lung cancer risk

The objective of this US study was to assess the association of toenail nicotine level as a novel biomarker with lung cancer risk independent of reported smoking history. A nested case-control study of 210 male lung cancer cases and 630 matched controls aged 40-75 years participating in the Health Professionals Follow-up Study was conducted. Toenail samples collected in 1987 were analyzed for nicotine levels, and incident lung cancer cases were diagnosed between 1988 and 2000. Mean toenail nicotine level among cases was 0.95 ng/mg compared with 0.25 ng/mg among controls (P < 0.0001). In univariate analyses, the relative risk of lung cancer for the highest versus lowest quintiles of toenail nicotine level was 10.50 (95% confidence interval: 5.61, 19.64; P for trend < 0.0001). When the authors adjusted for pack-years from reported smoking history in multivariate analyses, the relative risk for toenail nicotine levels in the highest quintile was still significant in predicting lung cancer risk: 3.57 (95% confidence interval: 1.73, 7.37; P for trend < 0.0001). In conclusion, the toenail nicotine biomarker was found to be a strong predictor of lung cancer independent of smoking history, suggesting that the adverse effects of cigarette smoke may be underestimated in studies based on smoking history only.     

State-specific trends in lung cancer incidence and smoking--United States, 1999-2008

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death in the United States. Most deaths from lung cancer are caused by cigarette smoking and exposure to secondhand smoke. Large variations in lung cancer, smoking behavior, and tobacco control programs and policies have been observed among states. Effective tobacco control policies can decrease smoking prevalence, ultimately leading to decreases in lung cancer. To assess lung cancer incidence by state, CDC analyzed data from the National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program for the period 1999-2008. To assess smoking behavior by state, data from the Behavioral Risk Factor Surveillance System (BRFSS) for the period 1994-2009 were analyzed. This report summarizes the results of these analyses. From 1999 to 2008, decreases in lung cancer incidence were observed among men in 35 states and among women in six states. Regionally, the lowest rates and most rapid rate of decline in lung cancer were concentrated among states in the West, correlating with low smoking prevalence and high ratios of former smokers to ever smokers. Further reductions in smoking prevalence are critical to continue the decline in lung cancer incidence.     

吸烟及烟碱型乙酰胆碱受体亚单位α5基因rs17486278位点多态性对肺癌的交互作用

目的 探讨在中国男性人群中吸烟、烟碱型乙酰胆碱受体亚单位α5(CHRNA5)基因多态性与肺癌的关联及其交互作用.方法 采用成组病例对照研究设计,收集男性原发性肺癌病例204例,正常健康对照者821例.采用结构式问卷调查社会人口学特征、吸烟行为及健康状况等,采集静脉血检测CHRNA5 SNP位点rs17486278的多态性.应用多因素logistic回归模型分析吸烟、CHRNA5的基因多态性与肺癌的关系及其交互作用.结果 控制潜在混杂因素后,每天吸烟量＞15支者发生肺癌的风险高于不吸烟者(OR=3.49,95％CI:2.29～ 5.32),未发现CHRNA5上的rs17486278多态性与肺癌有统计学关联.进一步交互作用分析显示,每天吸烟量1～15支并携带rs17486278纯合变异基因型(CC)者对肺癌的发生存在正交互作用(OR=16.13,95％CI:1.27～205.33).根据rs17486278多态性和吸烟行为进行分层分析,与不吸烟并携带rs17486278野生基因型(AA)者相比,每天吸烟量1～15支并携带纯合变异基因型(CC)者、每天吸烟量＞15支并携带野生基因型(AA)者和每天吸烟量＞15支并携带杂合变异基因型(AC)者发生肺癌风险增高,OR直分别为8.14(95％CI:1.17 ～ 56.56)、3.84(95％CI:1.30～ 11.40)和5.32(95％CI:1.78 ～ 15.93).结论 在中国男性人群中CHRNA5的基因多态性与吸烟行为对肺癌的发生存在正交互作用.     

Smoking prevalence and its impacts on lung cancer mortality in Sub-Saharan Africa: An epidemiological study

Background

Reliable mortality data are sparse for developing countries. Furthermore, risk factor prevalence information is hardly available and thus not taken into consideration when estimating mortality.

Methods

The authors used a validated, statistical model combined with representative smoking prevalence from WHO STEPS surveys to estimate lung cancer mortality for six Sub-Saharan African countries (Benin, Malawi, Mozambique, Niger, Sierra Leone, Swaziland). Results were compared to a reference database (GLOBOCAN). Using different smoking prevalence scenarios, future lung cancer deaths were estimated.

Results

The prevalence of current moderate smoking among males ranged from 8.7% to 34.6%. Prevalence was much lower among females. For all countries considered, our mortality estimates were higher than GLOBOCAN estimates that do not consider prevalence: Overall, we estimated 2405 lung cancer deaths for 2008 compared to 531 deaths estimated by GLOBOCAN. Up to 2030, lung cancer deaths are expected to increase in general and by over 100% in Benin and Niger. Even under the assumption of decrease in smoking prevalence, lung cancer mortality will rise.

Conclusion

On the bases of detailed smoking prevalence information, our findings implicate a higher lung cancer burden in low income countries. The epidemiologic transition in African low-income countries alludes to the need for targeted health prevention efforts.     

2019年重庆市30岁及以上人群归因于被动吸烟的肺癌疾病负担研究

目的 分析重庆市肺癌发病死亡和疾病负担归因于被动吸烟的情况,为开展肺癌防治提供建议。 方法 肺癌死亡个案数据来源于2019年重庆市肿瘤登记报告系统,被动吸烟率来自2013年重庆市慢性病及危险因素监测。计算人群归因危险度百分比(population attributable risk percent, PAR%)、被动吸烟导致的肺癌发病、死亡和疾病负担。采用Excel 2010与SPSS 25.0进行统计分析,率的比较采用χ²检验。 结果 2013年30岁及以上成年人被动吸烟率为52.37%。2019年重庆市30岁及以上人群肺癌发病率与标化发病率分别为118.44/10万与80.83/10万,死亡率与标化死亡率分别为96.51/10万、63.58/10万。肺癌发病率和死亡率归因于被动吸烟的PAR%分别为19.76和19.04,归因发病率与归因标化发病率分别为23.41/10万和16.34/10万,归因死亡率与归因标化死亡率分别为18.38/10万和12.40/10万。2019年重庆市30岁及以上肺癌早死所致寿命损失年率(years of life lost,YLL)、残疾所致寿命损失年率(years lived with disability,YLD)、调整伤残寿命损失年率(disability adjusted life year,DALY)分别为21.16‰、0.31‰、21.47‰,YLL率、YLD率、DALY率归因于被动吸烟的PAR%分别为21.16、19.76和20.49,归因YLL率为4.34‰,归因YLD率为0.06‰,归因DALY率为4.40‰。 结论 2019年重庆市30岁及以上人群肺癌发病率、死亡率、YLL率、DALY率高,被动吸烟率高,肺癌归因于被动吸烟的疾病负担重,应加强落实控烟工作。     

女性非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟者中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ－ＭＯＮＩＣＡ项目监测人群中的肺癌病例进行了调查，分析结果显示被动吸烟与非吸烟女性患肺癌有一定阳性关联（ＯＲ＝２．５２，Ｐ＜０．０５），并随被动吸烟年支的增加而上升，当达２００年支以上时有显著统计学意义（Ｐ＜０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ＜０．０５），而与肺鳞癌似无关系（ＯＲ＝１．０４，Ｐ＜０．０５）。     

Smoking cessation and lung cancer mortality in a cohort of middle-aged Canadian women

PURPOSE: To determine the impact of smoking cessation on lung cancer mortality among women. METHODS: Survival analysis is used to assess the effect of smoking cessation on lung cancer death in the dietary cohort of 49,165 women aged 40 to 59 years enrolled in the Canadian National Breast Screening Study. RESULTS: During an average of 10.3 years of follow-up, 106 women died of lung cancer. The risk of lung cancer mortality among women who quit before age 50 (HR=0.26; 95% CI, 0.13-0.55 among women who quit at ages 40-49) or quit in the previous 10 years (HR=0.39; 95% CI, 0.22-0.69) is substantially lower than the risk among current smokers. Women who quit after age 40 or have quit for less than 20 years are at substantially higher risk of lung cancer mortality compared with never smokers. Both duration of smoking cessation and age at quitting have independent effects on lung cancer mortality, after controlling for number of cigarettes smoked per day and number of years smoked, as well as other potential confounding variables. CONCLUSION: These findings suggest that programs and policies to promote early cessation of smoking and prevention of relapse should be a public health priority.