Lung cancer rates in men and women with comparable histories of smoking
Lung cancer rates in men and women with comparable histories of smoking
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DOI：
10.1093/jnci/djh143
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发表时间：
2004-06-02
影响因子：
10.3
通讯作者：
Colditz, GA
中科院分区：
文献类型：
--
作者：
Bain, C;Feskanich, D;Colditz, GA
背景资料：最近的病例对照研究表明，在同等吸烟暴露的情况下，妇女患肺癌的相对风险可能高于男子。尽管前瞻性数据与这一假设相冲突，但仍在继续进行机械研究，以找到性别差异的生物学基础。研究方法：我们通过分析两个大型研究群体（女性护士健康研究和男性健康专业人员随访研究）中既往和当前吸烟者的前瞻性数据，直接解决了这一假设。我们使用考克斯比例风险模型计算了女性与男性相比的肺癌发病率和风险比，并对年龄、每天吸烟数量、开始吸烟的年龄和戒烟时间进行了调整。我们还回顾了前瞻性分析的已发表结果。结果如下：从1986年到2000年，在60 296名女性和25 397名男性中分别确定了955和311例原发性肺癌，年龄从40岁到79岁不等。女性和男性的发病率每10万人年分别为253和232，在目前的吸烟者和81和73，分别为前吸烟者。与男性相比，女性吸烟者的风险比为1.11（95%置信区间= 0.95至1.31）。6项已发表的前瞻性队列研究允许按性别评估肺癌的相对易感性。没有人支持女性患肺癌的风险过高。结论：在相同的吸烟暴露量下，女性似乎并不比男性更易患肺癌。研究应侧重于加强所有人的预防性干预措施。
Background: Recent case-control studies suggest that, given equal smoking exposure, women may have a higher relative risk of developing lung cancer than men. Despite prospective data that conflict with this hypothesis, mechanistic studies to find a biologic basis for a sex difference continue. Methods: We addressed the hypothesis directly by analyzing prospective data from former and current smokers in two large cohorts-the Nurses' Health Study of women and the Health Professionals Follow-up Study of men. We calculated incidence rates and hazard ratios of lung cancer in women compared with men, adjusting for age, number of cigarettes smoked per day, age at start of smoking, and time since quitting, using Cox proportional hazards models. We also reviewed published results from prospective analyses. Results: From 1986 through 2000, 955 and 311 primary lung cancers were identified among 60 296 women and 25 397 men, respectively, who ranged in age from 40 to 79 years. Incidence rates per 100 000 person-years for women and men were 253 and 232, respectively, among current smokers and 81 and 73, respectively, among former smokers. The hazard ratio in women ever smokers compared with men was 1.11 (95% confidence interval = 0.95 to 1.31). Six published prospective cohort studies allowed assessment of comparative susceptibility to lung cancer by sex. None supported an excess risk of lung cancer for women. Conclusions: Women do not appear to have a greater susceptibility to lung cancer than men, given equal smoking exposure. Research should be focused on enhancing preventive interventions for all.