Analysis of lung cancer incidence in the nurses' health and the health professionals' follow-up studies using a multistage carcinogenesis model
Analysis of lung cancer incidence in the nurses' health and the health professionals' follow-up studies using a multistage carcinogenesis model
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DOI：
10.1007/s10552-007-9094-5
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发表时间：
2008-04-01
影响因子：
2.3
通讯作者：
Moolgavkar, Suresh H.
中科院分区：
文献类型：
--
作者：
Meza, Rafael;Hazelton, William D.;Moolgavkar, Suresh H.
我们在护士健康研究 (NHS) 和卫生专业人员随访研究 (HPFS) 中使用两阶段克隆扩增 (TSCE) 模型分析了非吸烟者、持续吸烟者和戒烟者的肺癌发病率。两个队列中非吸烟者的特定年龄肺癌发病率相同。在该模型的框架内，香烟烟雾的主要作用是促进部分改变的细胞通往癌症的途径。女性中与吸烟相关的晋升率较高，而与吸烟相关的恶性转化率较低。在这两个队列中，特定每日吸烟水平的相对风险随持续时间的变化而发生很大变化。在吸烟者中，NHS 中的发病率相对于 HPFS 中的发病率取决于吸烟强度和持续时间。 NHS 中年龄调整后的风险稍大一些，但并不显着。吸烟者戒烟后，风险会在多年内下降，下降的时间模式与最近其他研究报告的相似。在戒烟者中，NHS 中的发病率相对于 HPFS 中的发病率取决于之前的吸烟水平和戒烟后的时间。 NHS 中戒烟者的年龄调整风险略高，可能是由于两个群体之间的年龄分布差异所致。
We analyzed lung cancer incidence among non-smokers, continuing smokers, and ex-smokers in the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) using the two-stage clonal expansion (TSCE) model. Age-specific lung cancer incidence rates among non-smokers are identical in the two cohorts. Within the framework of the model, the main effect of cigarette smoke is on the promotion of partially altered cells on the pathway to cancer. Smoking-related promotion is somewhat higher among women, whereas smoking-related malignant conversion is somewhat lower. In both cohorts the relative risk for a given daily level of smoking is strongly modified by duration. Among smokers, the incidence in NHS relative to that in HPFS depends both on smoking intensity and duration. The age-adjusted risk is somewhat larger in NHS, but not significantly so. After smokers quit, the risk decreases over a period of many years and the temporal pattern of the decline is similar to that reported in other recent studies. Among ex-smokers, the incidence in NHS relative to that in HPFS depends both on previous levels of smoking and on time since quitting. The age-adjusted risk among ex-smokers is somewhat higher in NHS, possibly due to differences in the age-distribution between the two cohorts.