Smoking and subsequent risk of leukemia in Japan: The Japan Public Health Center-based Prospective Study

Abstract

BackgroundCigarette smoking has been reported to be associated with an increased risk of leukemia. Most epidemiological evidence on the association between cigarette smoking and leukemia risk is from studies conducted in Western populations, however, and evidence from Asian populations is scarce.MethodsWe conducted a large-scale population-based cohort study of 96,992 Japanese subjects (46,493 men and 50,499 women; age 40–69 years at baseline) with an average 18.3 years of follow-up, during which we identified 90 cases of acute myeloid leukemia (AML), 19 of acute lymphoblastic leukemia (ALL), and 28 of chronic myeloid leukemia (CML). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a Cox regression model adjusted for potential confounders.ResultsWhen we adjusted for age, sex, and study area, our findings showed no significant association or increasing dose–response relationship between risk of AML and cigarette smoking overall. However, after further adjustment for body mass index and occupation, current smokers with more than 30 pack-years of cigarette smoking had a significantly increased risk of AML compared to never smokers among men (HR 2.21; 95% CI, 1.01–4.83). This increased risk was not clear among women.ConclusionsOur results suggest that cigarette smoking increases the risk of AML in Japanese men. The associations of smoking with AML among women, and with CML and ALL among men and women, should be assessed in future studies.

Smoking and subsequent risk of acute myeloid leukaemia: A pooled analysis of 9 cohort studies in Japan

“…pack-years of cigarette smoking had a significantly increased risk of AML compared to never smokers (HR 2.21, 95% CI, 1.01-4.83) among Japanese men. 14 The present pooled analysis of prospective cohorts, including the JPHC study, confirmed that cigarette smoking increases the risk of AML in the Japanese population. In addition, results were not substantially changed when the JPHC study was excluded, suggesting that our findings were not due to the JPHC study only.…”

“…Another case‐control study in China (722 cases and 1444 controls) reported that cigarette smoking increased the risk of AML, with an odds ratio of 1.28 (95% CI, 1.00‐1.63) for ever smokers relative to never smokers . Recently, the JPHC study, one of the 9 cohorts in this pooled analysis, reported that current smokers with more than 30 pack‐years of cigarette smoking had a significantly increased risk of AML compared to never smokers (HR 2.21, 95% CI, 1.01‐4.83) among Japanese men . The present pooled analysis of prospective cohorts, including the JPHC study, confirmed that cigarette smoking increases the risk of AML in the Japanese population.…”

“…Indeed, until recently, only 2 case‐control studies had evaluated this association in Asia . Last year, the Japan Public Health Center (JPHC)–based Prospective Study reported that cigarette smoking increases the risk of AML in Japanese men . This was the first cohort study to evaluate the association between smoking and the risk of AML in an Asian population.…”

Smoking influences the outcomes of patients receiving tyrosine kinase inhibitors for chronic myeloid leukemia in the chronic phase: A retrospective analysis

“…Recent epidemiological studies revealed that smoking is a potential risk factor for chronic myeloid leukemia (CML) . However, the clinical CML features and outcomes in patients who have a history of smoking have not been well investigated, and we hypothesized that accounting for such a history might play a critical role in optimizing CML therapy or managing adverse events during TKI therapy.…”

“…Recent epidemiological studies revealed that smoking is a potential risk factor for chronic myeloid leukemia (CML). 6,7 However, the clinical CML features and outcomes in patients who have a history of smoking have not been well investigated, and we hypothesized that accounting for such a history might play a critical role in optimizing CML therapy or managing adverse events during TKI therapy. Therefore, we reviewed patients recorded in the CML Cooperative Study Group database and compared the clinical characteristics, treatment outcomes, and experienced complications between smokers and nonsmokers undergoing TKI therapy for CML.…”