Marijuana smoking and the risk of head and neck cancer: pooled analysis in the INHANCE consortium.
Marijuana smoking and the risk of head and neck cancer: pooled analysis in the INHANCE consortium.
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DOI：
10.1158/1055-9965.epi-08-0845
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发表时间：
2009-05
期刊：
影响因子：
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通讯作者：
Hashibe M
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文献类型：
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作者：
Berthiller J;Lee YC;Boffetta P;Wei Q;Sturgis EM;Greenland S;Morgenstern H;Zhang ZF;Lazarus P;Muscat J;Chen C;Schwartz SM;Eluf Neto J;Wünsch Filho V;Koifman S;Curado MP;Matos E;Fernandez L;Menezes A;Daudt AW;Ferro G;Brennan P;Hashibe M
大麻含有类似于烟草烟雾的致癌物质，相对较小的研究表明，它会增加头颈癌（HNC）的风险。由于烟草是HNC的主要风险因素，因此对大量从不吸烟者的大型研究可能有助于澄清吸食大麻是否与HNC风险独立相关。我们汇总了来自INHANCE联盟内五项病例对照研究的4，029例HNC病例和5，015例对照的大麻吸烟和已知HNC风险因素的自我报告访谈数据。在从不吸烟者（493例和1，813例对照）以及不饮酒或吸烟的人（237例和887例对照）中进行了亚组分析。HNC的风险并没有因吸食大麻而升高（比值比（OR）=0.88，95%置信区间（CI）=0.67，1.16），并且没有增加与吸食大麻的频率，持续时间或累积消费量相关的风险增加。在从不吸烟者中未检测到与大麻使用相关的HNC风险增加（OR=0.93，95%CI=0.63，1.37;三项研究），也未在不饮酒和吸烟的个体中检测到（OR=1.06，95%CI=0.47，2.38;两项研究）。我们的研究结果与不经常吸食大麻不会带来这些恶性肿瘤风险的观点一致。尽管如此，由于在大多数参与研究的人群中，经常吸食大麻的患病率很低，我们不能排除风险适度增加的可能性，特别是在没有接触烟草和酒精的亚组中。
Marijuana contains carcinogens similar to tobacco smoke and has been suggested by relatively small studies to increase the risk of head and neck cancer (HNC). Since tobacco is a major risk factor for HNC, large studies with substantial numbers of never tobacco users could help to clarify whether marijuana smoking is independently associated with HNC risk. We pooled self-reported interview data on marijuana smoking and known HNC risk factors on 4,029 HNC cases and 5,015 controls from five case-control studies within the INHANCE Consortium. Subanalyses were conducted among never tobacco users (493 cases and 1,813 controls), and among individuals who did not consume alcohol or smoke tobacco (237 cases and 887 controls). The risk of HNC was not elevated by ever marijuana smoking (odds ratio (OR) =0.88, 95% confidence intervals (CI) =0.67, 1.16), and there was no increasing risk associated with increasing frequency, duration or cumulative consumption of marijuana smoking. An increased risk of HNC associated with marijuana use was not detected among never tobacco users (OR=0.93, 95%CI=0.63, 1.37; three studies) nor among individuals who did not drink alcohol and smoke tobacco (OR=1.06, 95%CI=0.47, 2.38; two studies). Our results are consistent with the notion that infrequent marijuana smoking does not confer a risk of these malignancies. Nonetheless, because the prevalence of frequent marijuana smoking was low in most of the contributing studies, we could not rule out a moderately increased risk, particularly among subgroups without exposure to tobacco and alcohol.