Smokeless and other noncigarette tobacco use and pancreatic cancer: A case-control study based on direct interviews
Smokeless and other noncigarette tobacco use and pancreatic cancer: A case-control study based on direct interviews
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DOI：
10.1158/1055-9965.epi-03-0033
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发表时间：
2004-01-01
影响因子：
3.8
通讯作者：
Silverman, DT
中科院分区：
文献类型：
--
作者：
Alguacil, J;Silverman, DT
吸烟是胰腺癌的一个重要和公认的原因。相比之下，很少有人知道吸烟雪茄，烟斗和使用无烟烟草对胰腺癌风险的影响。本研究的目的是检查非卷烟烟草使用（即，香烟（如雪茄、烟斗、无烟烟草）和胰腺癌的风险。1986-1989年期间，在亚特兰大、格鲁吉亚、底特律、密歇根和新泽西10个县的居民中进行了一项以人群为基础的胰腺癌病例对照研究。直接访谈成功地完成了526例新诊断的胰腺癌患者和2153名对照组，年龄30-79岁。这项分析仅限于终身不吸烟的香烟，并根据采访154例新诊断的胰腺外分泌癌和844例人口控制谁没有吸烟史。我们观察到与吸烟相关的风险增加的一致模式，尽管这些升高没有统计学意义。经常抽雪茄的参与者（即，每周至少抽一支雪茄，持续时间大于或等于6个月）的风险增加了70%[95%置信区间（CI）：0.9-3.3]，从未使用其他形式烟草的人风险增加了90%（95% CI：0.8-4.3）。吸烟超过一支雪茄/天的人[比值比（OR）= 1.8; 95% CI：0.8-4.2）和吸烟超过20年的人（OR = 1.9; 95% CI：0.9-3.9）的风险增加。吸烟量和吸烟时间增加的风险趋势是一致的，但没有统计学意义（分别为P = 0.17和P = 0.16）。与不吸烟者相比，经常使用无烟烟草的受试者患胰腺癌的风险增加40%（95%CI：0.5-3.6）。我们观察到随着无烟烟草使用的增加，风险略有显著增加（P = 0.04）;每周使用>2.5盎司无烟烟草的参与者的OR为3.5（95% CI：长期使用无烟烟草（即，>20岁）也与非显著性风险增加相关（OR = 1.5; 95%CI：0.6-4.0）。相比之下，烟斗吸烟者的风险没有增加（OR = 0.6; 95% CI：0.1-2.8）。我们的研究结果表明，大量使用无烟烟草，在较小程度上，抽雪茄可能会增加非吸烟者患胰腺癌的风险。
Cigarette smoking is an important and well-established cause of pancreatic cancer. In contrast, little is known about the effects of smoking cigars, pipes, and use of smokeless tobacco on pancreatic cancer risk. The objective of the present study was to examine the association between noncigarette tobacco use (i.e., Cigars, pipes, smokeless tobacco) and pancreatic cancer risk among nonsmokers of cigarettes. A population-based case-control study of pancreatic cancer was conducted during 1986-1989 among residents of Atlanta, Georgia, Detroit, Michigan, and 10 counties in New Jersey. Direct interviews were successfully completed with 526 newly diagnosed pancreatic cancer patients and 2153 controls ages 30-79 years. This analysis was restricted to lifelong nonsmokers of cigarettes and based on interviews with 154 cases newly diagnosed with carcinoma of the exocrine pancreas and 844 population controls who reported no history of cigarette smoking. We observed a consistent pattern of increased risk associated with cigar smoking, although these elevations were not statistically significant. Participants who smoked cigars regularly (i.e., at least one cigar/week for greater than or equal to 6 months) experienced a 70% increased risk [95% confidence interval (Cl): 0.9-3.3], and those who never used other form of tobacco had a 90% increased risk (95% CI: 0.8-4.3). Risk was elevated among those who smoked more than one cigar/day [odds ratio (OR) = 1.8; 95% CI: 0.8-4.2) and among those who smoked cigars > 20 years (OR = 1.9; 95% CI: 0.9-3.9). Trends in risk with increasing amount and duration smoked were consistent but not statistically significant (P = 0.17 and P = 0.16, respectively). Subjects who used smokeless tobacco regularly had a 40% increased risk of pancreatic cancer (95% CI: 0.5-3.6) compared with nonusers of tobacco. We observed a marginally significant increasing risk with increased use of smokeless tobacco (P = 0.04); participants who used >2.5 oz of smokeless tobacco a week had an OR of 3.5 (95% CI: Long-term use of smokeless tobacco (i.e., >20 years) was also associated with a nonsignificant increased risk (OR = 1.5; 95% CI: 0.6-4.0). In contrast, pipe smokers experienced no increased risk (OR = 0.6; 95% CI: 0.1-2.8). Our results suggest that heavy use of smokeless tobacco, and to a lesser extent, cigar smoking may increase the risk of pancreatic cancer among nonsmokers of cigarettes.