Tobacco smoking and chewing, alcohol drinking and lung cancer risk among men in Southern India
Tobacco smoking and chewing, alcohol drinking and lung cancer risk among men in Southern India
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DOI：
10.1002/ijc.11377
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发表时间：
2003-11-10
影响因子：
6.4
通讯作者：
Boffetta, P
中科院分区：
文献类型：
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作者：
Gajalakshmi, V;Hung, RJ;Boffetta, P
在印度，肺癌是最常见和最致命的癌症之一，吸烟仍然是其最重要的病因。我们研究的目的是研究不同的烟草消费形式，包括吸烟和咀嚼，对印度南部男性肺癌风险的影响，特别是比较比迪烟和卷烟对肺癌发生的影响。我们还评估了印度酒精饮料和非印度酒精饮料在肺癌发生中的可能作用。我们在金奈和特里凡得琅进行了病例对照研究。总共招募了778例肺癌病例和3,430例对照，其中包括1,503例癌症对照和1,927例健康对照。吸烟、吸比地烟、咀嚼和饮酒对肺癌风险的影响通过无条件多因素logistic回归估计。我们还应用广义加性模型（GAM）与局部加权运行线平滑（黄土）来寻找最合理的剂量-响应关系曲线。GAM的研究结果表明，吸烟35年或吸烟10年之后，香烟和比迪都会出现平稳期。30年以上只吸烟和只吸bidi的OR分别为4.54 （95%CI=2.96-6.95）和6.45 (95%CI=41.38-9.50)， 12年以上加权累计只吸烟和只吸bidi的OR分别为6.87 （95%CI=4.62-10.2）和10.7 （95%CI=5.82-19.6）。戒烟后，前吸烟者患肺癌的风险比前比迪吸烟者下降得更快。没有证据表明咀嚼和肺癌风险的影响，也没有明确的证据表明不吸烟者总体饮酒的影响，尽管在有限的权力下，印度人饮酒似乎仍然与肺癌风险相关（OR=2.67, 95%CI=1.02-7.02）。吸比地烟似乎比吸卷烟有更强的致癌作用：无论考虑吸烟的哪个方面，这种差异都是成立的。(C) 2003 Wiley-Liss, Inc。
In India, lung cancer is one of the most common and lethal cancers, and tobacco smoking remains its most important etiologic factors. The objective of our study is to examine the effects of different tobacco consumption forms, including smoking and chewing, on lung cancer risk of men in southern India, especially to compare the effects of bidi smoking to cigarette smoking on lung carcinogenesis. We also evaluated the possible role of Indian alcohol beverages and non-Indian alcohol beverages on lung carcinogenesis. We conducted a case-control study in Chennai and Trivandrum. In total, 778 lung cancer cases and 3,430 controls, including 1,503 cancer controls and 1,927 healthy controls, were recruited. The effects of cigarette, bidi smoking, chewing and alcohol drinking on the risk of lung cancer were estimated from unconditional multivariate logistic regression. We also applied the generalized additive model (GAM) with locally-weighted running-line smoothers (loess) to find the most plausible curve for the dose-response relationship. The results from GAM suggest a plateau after 35 years of smoking or 10 cigarette-equivalent pack-years for both cigarette and bidi. The OR is 4.54 (95%CI=2.96-6.95) and 6.45 (95%CI=41.38-9.50) for more than 30 years of cigarette-only and bidi-only smoking, respectively, and 6.87 (95%CI=4.62-10.2) and 10.7 (95%CI=5.82-19.6) for more than 12 weighted cumulative cigarette-only and bidi-only consumption, respectively. The lung cancer risk of former cigarette smokers drops down more quickly after quitting smoking compared to former bidi smokers. There is no evidence for the effect of chewing and lung cancer risk nor clear evidence of an effect of overall alcohol drinking among never-smokers, although Indian alcohol drinking seemed to remain associated with lung cancer risk under limited power (OR=2.67, 95%CI=1.02-7.02). Bidi smoking seems to have a stronger carcinogenic effect than cigarette smoking: this difference holds no matter which aspect of smoking was considered. (C) 2003 Wiley-Liss, Inc.