Accumulating evidence on passive and active smoking and breast cancer risk
Accumulating evidence on passive and active smoking and breast cancer risk
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DOI：
10.1002/ijc.21150
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发表时间：
2005-11-20
影响因子：
6.4
通讯作者：
Johnson, KC
中科院分区：
文献类型：
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作者：
Johnson, KC
该研究的目的是检查与被动吸烟和主动吸烟相关的乳腺癌风险，并探索研究之间的风险异质性。在20项关于被动吸烟和女性乳腺癌风险的研究中，有19项符合基本质量标准。乳腺癌的合并相对危险度估计值计算为1）终身非吸烟者定期被动暴露于烟草烟雾和2）吸烟的女性。他们与从不经常接触烟草烟雾的女性进行了比较。在终身非吸烟者中，与被动吸烟相关的乳腺癌合并风险估计值为1.27（95%置信区间（CI），1.11-1.45）。在具有更完整暴露评估的5项研究（均为病例对照研究）的子集中（关于被动吸烟暴露的3个主要来源的定量长期信息：儿童、成人住宅和职业），暴露的非吸烟者的合并风险估计值为1.90（95%CI，1.53-2.37）。对于被动暴露测量不太完整的14项研究，总体风险为1.08（95% CI，0.99-1.19），7项病例对照研究为1.16，7项队列研究为1.06，尽管4项亚洲队列研究中有3项的剂量反应结果表明风险增加。终生非吸烟者中与被动吸烟相关的绝经前乳腺癌总体风险为1.68（95% CI 1.33-2.12），14项研究中有5项研究的风险为2.19（95% CI 1.68-2.84）。与既不主动吸烟也不经常被动吸烟的女性相比，吸烟女性的乳腺癌风险估计值为1.46（95% CI 1.15-1.85）;更完整的被动暴露评估为2.08（95% CI 1.44-3.01），不太完整的被动暴露评估为1.15（95% CI 0.92-1.43）。全面的被动吸烟暴露评估研究表明，被动吸烟和主动吸烟是绝经前乳腺癌的危险因素。进行全面被动吸烟评估的队列研究将有所帮助，需要探索生物学机制的研究来解释被动和主动风险的意外相似性。(c)2005 Wiley-Liss，Inc.
The aim of the study was to examine the risk of breast cancer associated with passive and active smoking and to explore risk heterogeneity among studies. Nineteen of 20 located published studies of passive smoking and breast cancer risk among women met basic quality criteria. Pooled relative risk estimates for breast cancer were calculated for 1) life-long non-smokers with regular passive exposure to tobacco smoke and 2) women who smoked. They were compared to women categorized as never regularly exposed to tobacco smoke. The pooled risk estimate for breast cancer associated with passive smoking among life-long non-smokers was 1.27 (95% confidence interval (CI), 1.11-1.45). In the subset of 5 studies (all case-control studies) with more complete exposure assessment (quantitative long-term information on the 3 major sources of passive smoke exposure: childhood, adult residential and occupational), the pooled risk estimate for exposed non-smokers was 1.90 (95 % CI, 1.53-2.37). For the 14 studies with less complete passive exposure measures the risk was 1.08 (95% CI, 0.99-1.19) overall, 1.16 for 7 case-control and 1.06 for 7 cohort studies, although dose-response results in 3 of 4 Asian cohort studies suggested increased risk. The overall premenopausal breast cancer risk associated with passive smoking among life-long non-smokers was 1.68 (95% CI 1.33-2.12), and 2.19 (95% CI 1.68-2.84) for the 5 of 14 studies with more complete exposure assessment. For women who had smoked the breast cancer risk estimate was 1.46 (95% CI 1.15-1.85) when compared to women with neither active nor regular passive smoke exposure; 2.08 (95% CI 1.44-3.01) for more complete and 1.15 (95% CI 0.92-1.43) for less complete passive exposure assessment. Studies with thorough passive smoking exposure assessment implicate passive and active smoking as risk factors for premenopausal breast cancer. Cohort studies with thorough passive smoking assessment would be helpful and studies exploring biological mechanisms are needed to explain the unexpected similarity of the passive and active risks. (c) 2005 Wiley-Liss, Inc.