Cigarette smoking and bladder cancer: a new twist in an old saga?
Cigarette smoking and bladder cancer: a new twist in an old saga?
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吸烟与膀胱癌：古老传奇的新转折？
DOI：
10.1093/jnci/djp385
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Hébert,JamesR
中科院分区：
文献类型：
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作者：
Alberg,AnthonyJ;Hébert,JamesR
到目前为止，香烟致癌特性的变化已被广泛研究用于肺癌，并且已知这种风险随着时间的推移而增加（13）。此外，当对1959年建立的随访至1965年的队列和1982年建立的随访至1988年的另一队列进行比较时，男性（RR= 2.7至3.5）和女性（RR= 1.8至2.6）的“其他吸烟相关癌症”死亡率的相对风险增加（14）。在美国进行的队列研究中，报告了当前吸烟者相对于非吸烟者与膀胱癌发病率相关的RR。在马里兰州华盛顿县的连续和重叠队列中，未观察到相关性增加（第一队列中，当前吸烟者相对于非吸烟者的膀胱癌发病率RR= 2.7，从1963年至1988年;第二队列中，RR= 2.6，从1975年至1994年）（15）。在1966年至1988年的夏威夷队列中报告了类似的相对风险（RR= 2.9）（16）。在最近的几项队列研究中，报告的膀胱癌发病率在目前吸烟者中相对于非吸烟者明显更高：1976年至1982年基督复临安息日会为5.7（17），1986年至1998年爱荷华州妇女健康研究队列为5.5（18）。这一证据是模棱两可的，但当然不能排除这种关联随着时间的推移而变得越来越强。Baris et al. (7)是挑衅性的，并伴随着一个站得住脚的假设。回顾稳步积累的证据和谨慎的推论，最终导致确定吸烟导致膀胱癌，这些有趣的发现提供了一个可验证的假设，值得进行彻底的调查。这项研究的一个重要内容将是更精确地确定卷烟添加剂的具体作用将是这项研究的一个重要内容。这项研究强调了在监测改变香烟内容和设计对疾病风险的影响方面需要继续保持警惕，并表明改变香烟内容和设计对公共卫生的影响可能是严重的。
So far, the changing carcinogenic properties of cigarettes have been studied most extensively for lung cancer, and it is known that this risk has increased over time (13). Furthermore, the relative risks of mortality from “other smoking-related cancers” increased for both men (RR= 2.7 to 3.5) and women (RR= 1.8 to 2.6) when a cohort established in 1959, with follow-up through 1965, and another cohort established in 1982, with follow-up through 1988, were compared (14). In cohort studies carried out in the United States, that reported the RR for current smokers relative to nonsmokers in relation to bladder cancer incidence. No increase in the association was observed in successive and overlapping cohorts in Washington County, Maryland (RR= 2.7 for bladder cancer incidence in current smokers relative to nonsmokers in the first cohort, followed from 1963 to 1988; RR= 2.6 in the second cohort, followed from 1975 to 1994)(15). A similar relative risk (RR= 2.9) was reported in a Hawaiian cohort followed from 1966 to 1988 (16). In a few recent cohort studies, reported RRs of bladder cancer incidence among current smokers relative to nonsmokers were notably higher: 5.7 in Seventh Day Adventists followed from 1976 to 1982 (17) and 5.5 in the Iowa Women’s Health Study cohort followed from 1986 to 1998 (18). This evidence is equivocal but certainly does not rule out that the association has grown stronger over time. The findings of Baris et al.(7) are provocative and are accompanied by a tenable hypothesis. Recalling the steady accumulation of evidence and the cautious inferences that eventually led to the determination that smoking causes bladder cancer, these intriguing findings offer a testable hypothesis that warrants thorough investigation. An important element of this research will be to more precisely, pinpoint the specific role of cigarette additives will be an important element of this research. This study highlights the need for continued vigilance in monitoring the impact of changing cigarette content and design on disease risk, and demonstrates that the public health implications of the changing cigarette content and design are potentially severe.