Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi-site case-control study
Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi-site case-control study
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DOI：
10.1111/j.1349-7006.2003.tb01480.x
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发表时间：
2003-06-01
期刊：
影响因子：
5.7
通讯作者：
Tateno, H
中科院分区：
文献类型：
--
作者：
Minami, Y;Tateno, H
虽然吸烟是肺癌的一个众所周知的危险因素，但在日本，吸烟与其他部位风险的关系尚未完全阐明。为了同时评价吸烟与胃癌、肺癌、结肠癌和直肠癌（近年来在日本宫城县的主要癌症部位）风险的关系，我们进行了一项以医院为基础的病例对照研究。研究对象包括614例胃癌，515例肺癌，324例结肠癌和164例直肠癌病例，以及1997年至2001年在宫城县一家医院收治的2444例医院对照。吸烟习惯和其他生活方式因素的信息收集使用自填式问卷。同时调查了转诊基数在病例组和对照组中的分布情况。对于每个站点，使用非条件logistic回归模型，分别对年龄、调查年份、饮酒史、索引癌症家族史和职业史进行校正，估计吸烟习惯的比值比（OR）和95%置信区间（95%Cls）。吸烟（曾经吸烟与从不吸烟）与男性胃癌（OR=1.62; 95%CI 1.20-2.19）和肺癌（OR=3.82; 95%CI 2.49-5.86）以及女性肺癌（OR=2.02; 95%CI 1.28-3.18）的风险增加相关。女性胃癌与吸烟的关系不确定（OR=0.65，P=0.1533）。对于直肠癌，在两性合并分析中观察到风险显著增加。吸烟与结肠癌风险之间没有联系。详细的分析表明，吸烟与癌症风险的关联可能会受到患者转诊模式的影响，即，筛选或不筛选。目前的研究结果表明，吸烟与癌症风险的关联可能因地点和性别而异。就人群归因风险而言，男性主要癌症的大部分似乎与吸烟有关。
Although cigarette smoking is a well-known risk factor of lung cancer, associations of cigarette smoking with the risk of other sites have not been fully elucidated in Japan. To simultaneously evaluate the associations of cigarette smoking with the risks of cancers of the stomach, lung, colon, and rectum, which have been the leading cancer sites in recent years in Miyagi Prefecture, Japan, we conducted a hospital-based case-control study. Study subjects consisted of 614 stomach, 515 lung, 324 colon, and 164 rectal cancer cases and 2444 hospital controls admitted to a single hospital in Miyagi Prefecture from 1997 to 2001. Information on smoking habit and other lifestyle factors was collected using a self-administered questionnaire. Distributions of referral base among cases and controls were also investigated. For each site, odds ratios (ORs) and 95% confidence intervals (95% Cls) for smoking habit were estimated with adjustment for age, year of survey, history of alcohol drinking, family history of index cancer, and occupational history, respectively, using an unconditional logistic regression model. Cigarette smoking (ever vs. never) was associated with an increased risk of stomach (OR=1.62; 95% Cl 1.20-2.19) and lung (OR=3.82; 95% CI 2.49-5.86) cancer among males and lung cancer among females (OR=2.02; 95% Cl 1.28-3.18). For female stomach cancer, the association with cigarette smoking was uncertain (OR=0.65, P=0.1533). For rectal cancer, a significant increased risk was observed in both-sex-combined analysis. There was no association between cigarette smoking and the risk of colon cancer. Detailed analysis showed that the association of cigarette smoking with cancer risk might be modified by the patient referral pattern, i.e., screened or not screened. The present results indicate that the association of cigarette smoking with cancer risk may differ among sites and sexes. In terms of the population attributable risk, a large proportion of leading cancers in males appears to be related to cigarette smoking.