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
Abstract : 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.
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Submitted on : Monday, August 6, 2012 - 7:56:28 PM
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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, Wiley, 2012, 131 (5), pp.1210-9. ⟨10.1002/ijc.27339⟩. ⟨pasteur-00722977⟩

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