Cigarette smoking and lung cancer-relative risk estimates for the major histological types from a pooled analysis of case-control studies.

Beate Pesch (1) , Benjamin Kendzia (1) , Per Gustavsson (2) , Karl-Heinz Jöckel (3) , Georg Johnen (1) , Hermann Pohlabeln (4) , Ann Olsson (2, 5) , Wolfgang Ahrens (4) , Isabelle Mercedes Gross (1) , Irene Brüske (6) , Heinz-Erich Wichmann (6) , Franco Merletti (7) , Lorenzo Richiardi (7) , Lorenzo Simonato (8) , Cristina Fortes (9) , Jack Siemiatycki (10) , Marie-Elise Parent (10, 11) , Dario Consonni (12) , Maria Teresa Landi (13) , Neil Caporaso (13) , David Zaridze (14) , Adrian Cassidy (15) , Neonila Szeszenia-Dabrowska (16) , Peter Rudnai (17) , Jolanta Lissowska (18) , Isabelle Stücker (19) , Eleonora Fabianova (20) , Rodica Stanescu Dumitru (21) , Vladimir Bencko (22) , Lenka Foretova (23) , Vladimir Janout (24) , Charles M Rudin (25) , Paul Brennan (5) , P. Boffetta (26, 27) , Kurt Straif (5) , Thomas Brüning (1)

1 IPA - Institute for Prevention and Occupational Medicine of the German Social Accident Insurance
2 IMM - The Institute of Environmental Medicine [Stockholm]
3 Institute for Medical Informatics, Biometry, and Epidemiology
4 Bremen Institute for Prevention Research and Social Medicine
5 IACR - International Agency for Cancer Research
6 Institute of Epidemiology
7 Cancer Epidemiology Unit
8 Department of Environmental Medicine and Public Health
9 Clinical Epidemiology Unit
10 CR CHUM - Centre de Recherche du Centre Hospitalier de l’Université de Montréal
11 INRS-IAF - Institut Armand Frappier
12 Unit of Epidemiology
13 Division of Cancer Epidemiology and Genetics
14 Institute of Carcinogenesis
15 Roy Castle Lung Cancer Research Programme
16 The Nofer Institute of Occupational Medicine
17 National Institute of Environment Health
18 The M Sklodowska-Curie Cancer Center
19 Epidémiologie environnementale des cancers
20 Department of Occupational Health
21 INSP - National Institute of Public Health [Romania]
22 Institute of Hygiene and Epidemiology
23 MMCI - Masaryk Memorial Cancer Institute
24 Department of Preventive Medicine
25 The Sidney Kimmel Comprehensive Cancer Center
26 The Tisch Cancer Institute
27 IPRI - International Prevention Research Institute

Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.

Keywords: cigarette smoking; lung cancer; relative risk characterization; tobacco smoke; stem cells

Domains: Cancer

Beate Pesch, Benjamin Kendzia, Per Gustavsson, Karl-Heinz Jöckel, Georg Johnen, et al.. Cigarette smoking and lung cancer-relative risk estimates for the major histological types from a pooled analysis of case-control studies.. International Journal of Cancer, 2012, 131 (5), pp.1210-9. ⟨10.1002/ijc.27339⟩. ⟨pasteur-00722977⟩