Meta-analysis of disease risk associated with smoking, by gender and intensity of smoking.
Meta-analysis of disease risk associated with smoking, by gender and intensity of smoking.
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DOI：
10.1016/s1550-8579(06)80216-0
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发表时间：
2006-12-01
期刊：
影响因子：
--
通讯作者：
Dirani, Riad
中科院分区：
文献类型：
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作者：
Mucha, Lisa;Stephenson, Judith;Dirani, Riad
背景：与吸烟相关的风险可能是巨大的，特别是对女性。2000年，妇女肺癌死亡率高于乳腺癌死亡率。目的：为了获得男性和女性吸烟强度的总体风险，对最近的研究进行了荟萃分析，评估了与吸烟相关的发病率和死亡率。方法：利用PubMed数据库，检索有关吸烟对发病率和死亡率影响的队列和病例对照研究的文献。只有量化了与吸烟相关的疾病风险的研究才被纳入其中。选择了19项研究，获得了有关吸烟对疾病影响的数据、风险点估计、95% ci、样本量、研究类型和男女患者人数。对低水平吸烟者进行荟萃分析，定义为每天1至20支香烟，对高水平吸烟者进行荟萃分析，定义为每天100至20支香烟。结果：对于低水平使用，女性的比率点估计值为1.77 （95% CI, 1.40-2.24）高于男性的1.42 (95% CI, 1.23-1.64)，表明性别效应与吸烟作为疾病风险相关。高水平吸烟的女性的点估计值为2.75 (95% CI, 2.14-3.52)，远远超过男性的估计值1.95 (95% CI, 1.70-2.24)，表明高水平吸烟存在实质性的性别影响。所有关于低水平和高水平吸烟的点估计都是显著的；无论男女，高水平吸烟的人都比低水平吸烟的人多。女性从低水平到高水平吸烟的风险增加幅度大于男性。结论：人体中很少有系统不受吸烟影响，吸烟强度是疾病的危险因素。结果与先前的研究一致，并加强了吸烟强度增加导致总体风险增加的研究。此外，还注意到性别差异可能对风险程度有所影响。
BACKGROUND: The risks associated with cigarette smoking can be substantial, particularly for females. In 2000, the mortality rate for lung cancer among women was higher than that for breast cancer.OBJECTIVE: To obtain overall risk for intensity of smoking for both males and females, a meta-analysis was performed on recent studies that assessed the morbidity and mortality associated with smoking.METHODS: Using the PubMed database, a literature search was conducted for cohort and case-control studies on the effect of smoking on morbidity and mortality. Only studies that had quantified the risk of disease associated with smoking were included. Nineteen studies were selected, with data obtained on the disease affected by smoking, point estimates of risk, 95% CIs, sample size, type of study, and the number of patients of each sex. Meta-analyses were performed for low level of use, defined as 1 to 20 cigarettes per day, and for high level of use, >20 cigarettes per day.RESULTS: For low level of use, the rate ratio point estimate of 1.77 (95% CI, 1.40-2.24) for females was higher than that of 1.42 (95% CI, 1.23-1.64) for males, indicating a gender effect associated with smoking as a disease risk. The point estimate for females who smoked at high levels was 2.75 (95% CI, 2.14-3.52), well beyond the estimate of 1.95 (95% CI, 1.70-2.24) for males, indicating there was a substantial gender effect with high-level use. All point estimates for low and high levels of smoking were significant; those for each sex at high levels of smoking exceeded those found for low levels. The increase in risk from low to high levels of smoking was greater for females than for males.CONCLUSIONS: Few systems in the body were unaffected by smoking, and intensity was a risk factor for disease. Results were consistent with and strengthened previous research demonstrating an increase in overall risk with an increase in smoking intensity. In addition, gender differences were noted that may contribute to risk magnitude.