FIVE AUTHORS REPLY.
FIVE AUTHORS REPLY.
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五位作者回复。
DOI：
10.1093/aje/kwx352
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发表时间：
2018
影响因子：
5
通讯作者：
Ye,Weimin
中科院分区：
文献类型：
--
作者：
Chang,EllenT;Liu,Zhiwei;Hildesheim,Allan;Adami,Hans-Olov;Ye,Weimin
我们感谢《华尔街日报》给我们机会回复 Zou 等人 (1) 关于我们的文章 (2) 的来信，并纠正一些关于我们的研究和鼻咽癌 (NPC) 流行病学的误解。首先，我们在研究的 3 个地理区域中一致观察到吸烟与 NPC 风险之间呈正相关，这表明温度或湿度没有明显的影响。同样，在亚洲、非洲、欧洲和北美的一系列地理区域中也观察到吸烟与鼻咽癌风险之间呈正相关 (3)。其次，之前的研究还没有证明鼻咽癌发病的季节性，如果中国东南部春季的炎热和潮湿影响了疾病风险，这可能是可以预料到的。第三，即使温度和湿度是鼻咽癌的危险因素，它们也不应该与主动或被动吸烟相关，因此不会混淆这些暴露与鼻咽癌风险的关联。最后，我们控制了对居住城市的分析，这在很大程度上会根据天气对 NPC 风险的影响进行调整。因此，我们继续得出结论，我们在华南地区进行的基于人群的病例对照研究的结果表明，主动和被动吸烟与鼻咽癌风险之间存在正相关关系，其中长期主动吸烟者与童年或配偶被动吸烟者之间的关联尤其强烈。我们赞赏 Zou 等人的假设 (1)，即中国东南部春季的炎热和潮湿可能会促进鼻咽部和/或当地种植的粮食作物中细菌和真菌的过度生长。进一步的研究有助于阐明这些因素是否通过与吸烟相互作用而促进鼻咽癌的发生。
We thank the Journal for the opportunity to reply to the letter from Zou et al.(1) concerning our article (2) and to correct some misconceptions regarding our study and the epidemiology of nasopharyngeal cancer (NPC) in general. First, we consistently observed a positive association between smoking and NPC risk across the 3 geographic areas in our study, indicating no clear effect modification by temperature or humidity. Likewise, a positive association between smoking and NPC risk has been observed in a range of geographic areas in Asia, Africa, Europe, and North America (3). Second, no previous study has demonstrated seasonality in the incidence of NPC, as might be expected if springtime heat and humidity in southeastern China affected disease risk. Third, even if temperature and humidity were risk factors for NPC, they should not be associated with active or passive tobacco smoking, and therefore they would not confound the associations of these exposures with NPC risk. Finally, we controlled in our analysis for city of residence, which would largely have adjusted for any effect of weather on NPC risk. Thus, we continue to conclude that the results of our population-based case-control study in southern China demonstrated a positive association between active and passive tobacco smoking and NPC risk, with an especially strong association among long-term active smokers and those exposed to passive smoking in childhood or from a spouse. We appreciate the hypothesis of Zou et al.(1) that springtime heat and humidity in southeastern China might promote overgrowth of bacteria and fungi in the nasopharynx and/or in locally grown food crops. Further studies can help to clarify whether these factors, by interacting with smoking or not, contribute to promoting NPC carcinogenesis.