Cancer incidence in female smokers: A 26-year follow-up

Nordlund, Lars Anders; Carstensen, John; Pershagen, Göran

doi:10.1002/(sici)1097-0215(19971127)73:5<625::aid-ijc2>3.0.co;2-z

Cited by 80 publications

(49 citation statements)

References 14 publications

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“…[12][13][14][15][16][17][18][19][20][21][27][28][29][30][31][32][33][34][35][36] The magnitude of relative risk in Japan ranged from 3.7-5.1 for all histologic types combined, either from cohort or case-control studies. When divided by histologic type, findings from a case-control study indicated that odds ratios ranged from 4.3-21.4 for squamous cell and small cell carcinoma and from 1.5-3.7 for adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Sobue

Yamamoto

Hara

et al. 2002

Intl Journal of Cancer

146

116

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In order to update the findings of relative risk associated with cigarette smoking for lung cancer by histologic type in Japan, the data from a population-based cohort study of 91,738 men and women were analyzed. During 1990 -1999, 422 lung cancer incident cases were identified. The relative risk for all incident cases associated with current smokers versus non-smokers was 4.5 [95% confidence interval (CI): 3.0 -6.8] and 4.2 (95% CI: 2.4 -7.2), for men and women, respectively. When divided by histologic type, relative risk for squamous cell carcinoma and small cell carcinoma was 12.7 (95% CI: 4.7-34.7) and 17.5 (95% CI: 4.9 -62.1), while for adenocarcinoma it was 2.8 (95% CI: 1.6 -4.9) and 2.0 (95% CI: 0.8 -5.0) for men and women, respectively. We confirmed that the lung cancer risk in men rose with increasing cigarette smoking, especially the duration of smoking among current smokers and decreased after the cessation of smoking among former smokers. Unlike the US or European countries, the relative risk did not increase in this updated study, compared with previous studies in 1960s to 1990s in Japan either for all incident cases or for specific histologic types and the magnitude of relative risks was substantially lower than that observed in the US or European countries, especially for adenocarcinoma. © 2002 Wiley-Liss, Inc. Key words: lung cancer; histologic type; cigarette smoking; relative riskRecent trends in lung cancer incidence showed a relative increase in adenocarcinoma as compared with squamous cell carcinoma for both men and women in various countries. [1][2][3][4][5][6] It is hypothesized that this trend is mainly due to the dissemination of low-tar filter cigarettes, 7-9 since filters mainly remove the larger particles in cigarette smoke, which tend to be deposited in the central large bronchus where most squamous cell carcinomas arise. However, such filters do not remove smaller particles, which tend to reach the peripheral region of the lung where adenocarcinomas arise. Moreover, in order to compensate for nicotine intake, smokers of low-tar filter cigarettes tend to inhale more deeply than those of nonfilter cigarettes, which results in more cigarette smoke reaching the peripheral region. Switching from nonfilter to filter cigarettes occurred mostly during in the US, the UK and Japan, where market share of filtered cigarette exceeded that of nonfilter cigarette in 1959, 1967 and 1965, respectively. 10,11 In the US and European countries, this hypothesis is supported by the finding that the magnitude of the relative risk of lung adenocarcinoma associated with cigarette smoking increased in recent studies, just when the usage of low-tar filter cigarette became more widespread among study subjects. It is reported from the US that the risk of lung adenocarcinoma is many times higher for current smokers than non-smokers, i.e., 19.0-fold for men and 8.1-fold for women in the Cancer Prevention Study (CPS) II (1982II ( -1984, while in CPS I (1959 -1961) corresponding estimates were 4.6 and 1.5 for me...

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Section: Discussionmentioning

confidence: 99%

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Sobue

Yamamoto

Hara

et al. 2002

Intl Journal of Cancer

146

116

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“…Moreover, we suspected that the number of daily cigarettes smoked in recent studies might be unstable, because some smokers might have tried to quit smoking, or others who reduced their number of cigarettes might have returned to their former number of cigarettes. We calculated mean number of cigarettes in the baseline survey and the second survey, which was conducted 5 years later, according to baseline categories (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), and 30+) for men. The means of number of cigarettes in each category were 11.2, 20.6, and 36.6 for the baseline survey, while those at the 5-year survey were 14.7, 20.9, and 31.1.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Prevalence of current cigarette smoking in Japan is higher than in the US and European countries, while relative risks (RRs) due to smoking and population attributable fraction (PAF) are lower in Japan. In the Cancer Prevention Study (CPS) II (1982-86), RRs due to smoking for all causes of death were reported 2.3 and 1.9 for men and women, respectively, and PAF% could be calculated 33% and 14% for men and women, respectively.…”

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confidence: 99%

Smoking and Risk of Premature Death among Middle‐aged Japanese: Ten‐year Follow‐up of the Japan Public Health Center‐based Prospective Study on Cancer and Cardiovascular Diseases (JPHC Study) Cohort I

Hara

Sobue

Sasaki

et al. 2002

Japanese Journal of Cancer Research

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To update the evidence on the association between smoking and mortality, we analyzed data from a population-based prospective study in Japan. In total, 19 950 men and 21 534 women aged 40-59 who reported their smoking history and had no serious disease at baseline survey were followed. During 1990-1999, 1014 men and 500 women died. Smokers were associated with an unhealthy lifestyle. Relative risks (RRs) for selected cause of death due to smoking were slightly attenuated by adjusting for possible confounding factors. Age-and area-adjusted RRs of male current smokers compared with never smokers were 1.66 (95% confidence intervals (CI Twenty-two percent of death from all causes, 25% of all cancer, and 17% of all circulatory system disease deaths, could be attributed to cigarette smoking in males, and 5%, 4%, and 11% in females, respectively. Cumulative dose as indicated by pack-years was clearly associated with cancer death. These findings provided information as to the quantitative risk for premature death due to smoking among middle-aged Japanese men and women, and showed that the elevated risk was not explained by the unhealthy lifestyle of smokers.Key words: Smoking -Mortality -Prospective study Cigarette smoking is an important and well-established risk factor of mortality and incidence of many cancers and cardiovascular disease.1-13) Prevalence of current cigarette smoking in Japan is higher than in the US and European countries, while relative risks (RRs) due to smoking and population attributable fraction (PAF) are lower in Japan. In the Cancer Prevention Study (CPS) II (1982-86), RRs due to smoking for all causes of death were reported 2.3 and 1.9 for men and women, respectively, and PAF% could be calculated 33% and 14% for men and women, respectively. 14) In Japan, RRs were reported to be 1.3 for either sex, while the PAF% was reported 18% and 4% for men and women, respectively, in a six-prefecture cohort study . 8)Because smokers are considered to have an unhealthy lifestyle, [15][16][17] smoking-related mortality has been considered to be affected by factors other than smoking itself, such as diet, alcohol, physical activity, and educational level. 13,[18][19][20][21][22] In the US, RRs of smoking for death were slightly altered by adjustment for other exposures in a recent study. 21) In Japan, Hirayama et al. conducted a sixprefecture cohort study , and established the risk of smoking, 8) although they calculated RRs while adjusting only for age. Since then, there have been no recent updates and no reports which analyzed RRs for death associated with tobacco smoking adjusted for other lifestyle-related factors from such a large cohort.Premature death represents a serious cost to society, and death at younger ages is one of the most important targets for future prevention of diseases. It is therefore of interest to study the etiological fraction of smoking in such premature death in the current Japanese population. In this study, we update the potential health hazards of cigarette smoking adjusted for ...

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“…Smoking was considered arisk factor for lung, breast and bladder cancer [18][19][20]. Prevalence of employees by economic activity (agriculture, industry, commerce, transport, financial activity, and other activity) was calculated on the basis of the 2011 Census data [14].…”

Section: Risk Factors Definitions and Related Diseasesmentioning

confidence: 99%

Cancer occurrence among women resident in the Gorizia province (North-Eastern Italy). May ecological data be used for adjusted epidemiological measures? Deterministic and probabilistic sensitivity analysis

Castriotta¹,

Rosolen²,

Bidoli³

et al. 2018

J Med Stat Inform

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Background: The evaluation of the confounders is crucial to accurately estimate the association between environmental factors and diseases. The deterministic sensitivity analysis permits an external adjustment of the observed measures of effect. The probabilistic sensitivity analysis allows to define several probability density functions for the bias parameters and to use these prior distributions tocalculate limits for the biasadjusted exposure-disease relative risks. The confounding effect of known risk factors, for lung, breast and bladder cancer, in women residing in the Gorizia Province (GP),was estimated. Methods: The deterministic sensitivity analysis was performed by calculating confounding risk ratios (CRRs) under different scenarios of confounding. Several parameterswere defined, as the population being studied; the prevalence of women residing in the GP and in the southern and northern Gorizia province (SGP and NGP respectively); the prevalence of the different risk factors in the selected areas;and the risk factordisease risk ratios per specific type of cancer. The CRRs were finally used to adjust theage-standardised rate ratios. Probabilistic sensitivity analysis allowed to specifyprior probability distributions for the lognormal risk factors-disease risk ratio with 95% lognormal confidence limits ln(RR1) and ln(RR2), mean and standard deviation equal to {ln(RR1)+ln(RR1)}/2 and {ln(RR2)*ln(RR1)}/(2*1.96) respectively. Results: In women resident in the GP, the age-standardisedIRR for bladder cancer is equal to 1.18 but, adjusting for smoking through deterministic analysis, the new IRR ranges from 1.13 to 1.25. In SGP the same age-standardised IRR is equal to 1.45 while after adjustment for smoking it ranges from 1.31 to 1.67. Adjusting for the deprivation index in the areas of interest, the IRRs for bladder cancer in GP range from 1.17 to 1.18 while in SGP resident from 1.45 to 1.47. Results from the probabilistic analysis show that the RR for bladder cancer inGP women, when adjusted for smoking results to be equal to 1.20 (2.5th -97.5th: 0.99 -1.44) when adjusted for deprivation, appears to be equal to 1.19 (2.5th -97.5th: 0.99 -1.43). In the SGPthe IRR for bladder cancer, when adjusted for smoking, results equal to 1.58 (2.5th -97.5th: 1.09 -2.25) when adjusted for deprivation, 1.57 (2.5th -97.5th: 1.10 -2.23). Regarding breast and lung cancers, no risk excess arises in the studied areas, even after adjustment in both deterministic and probabilistic analysis. Conclusions: Data on bladder cancer would seem to suggest a higher incidence of this cancer among the women residing in GP and, in particular, in the SGP. This excess risk isconfirmedafter adjustment for smoking and deprivation.No risk excesses in the studied areas for lung and breast cancers.

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Cancer incidence in female smokers: A 26-year follow-up

Cited by 80 publications

References 14 publications

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Smoking and Risk of Premature Death among Middle‐aged Japanese: Ten‐year Follow‐up of the Japan Public Health Center‐based Prospective Study on Cancer and Cardiovascular Diseases (JPHC Study) Cohort I

Cancer occurrence among women resident in the Gorizia province (North-Eastern Italy). May ecological data be used for adjusted epidemiological measures? Deterministic and probabilistic sensitivity analysis

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