Systematic Reviews and Meta- and Pooled Analyses Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium
Systematic Reviews and Meta- and Pooled Analyses Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium
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发表时间：
2013
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通讯作者：
A. Wyss;M. Hashibe;Shu-Chun Chuang;Y. Lee;Zuo‐Feng Zhang;Guo-Pei Yu;D. Winn;Q. Wei;R. Talamini-R.-Talam
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作者：
A. Wyss;M. Hashibe;Shu-Chun Chuang;Y. Lee;Zuo‐Feng Zhang;Guo-Pei Yu;D. Winn;Q. Wei;R. Talamini-R.-Talam
吸烟和烟斗被认为是头颈部癌症的危险因素，但这些产品的影响程度估计不准确。通过使用国际头颈癌流行病学（INHANCE）联盟的汇总数据，（包括1981年至2007年19项研究中的13，935例病例和18，691例对照），我们应用分层logistic回归更精确地估计香烟，雪茄和烟斗吸烟的比值比和95%置信区间，与那些从未吸过任何一种产品的参考组进行比较。雪茄和烟斗吸烟的优势比按吸烟史分层。我们还考虑了只吸一种产品与从未吸过任何产品（参考组）的效果估计。在从不吸烟者中，曾经吸烟的比值比为2.54（95%置信区间（CI）：1.93，3.34），曾经吸烟斗的比值比为2.08（95% CI：1.55，2.81）。这些比值比随着吸烟频率和持续时间的增加而增加（P趋势≤ 0.0001）。在曾经吸烟的人群中，抽雪茄和烟斗的优势比并没有升高。对于那些报告只抽雪茄（比值比= 3.49，95% CI：2.58，4.73）或只抽烟斗（比值比= 3.71，95% CI：2.59，5.33）的人，头颈部癌症的风险升高。这些结果表明，雪茄和烟斗吸烟与头颈癌风险增加独立相关。
Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking ( P trend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.