The association of cigarette smoking with gastric cancer: the multiethnic cohort study
The association of cigarette smoking with gastric cancer: the multiethnic cohort study
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DOI：
10.1007/s10552-011-9854-0
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发表时间：
2012-01-01
影响因子：
2.3
通讯作者：
Kolonel, Laurence N.
中科院分区：
文献类型：
--
作者：
Nomura, Abraham M. Y.;Wilkens, Lynne R.;Kolonel, Laurence N.
这项研究的目的是调查吸烟与胃癌的关系，在1993-1996年，来自五个种族（非裔美国人、日裔美国人、拉丁裔美国人、夏威夷土著人和白人）的215，000多名男性和女性完成了一份邮寄问卷。经过平均7.3年的随访，454名男性和242名女性被诊断为胃腺癌。考克斯比例风险模型用于计算多变量调整的风险比和95%置信区间，目前吸烟者与从不吸烟者相比，男性（HR = 1.98; 95%CI 1.46-2.70）和女性（HR = 1.78; 95%CI 1.23-2.57）的风险比升高。这种正相关在所有五个种族中是一致的。曾经吸烟的男性风险增加，但女性没有。在所有当前吸烟者中，吸烟强度（每天吸烟支数）和持续时间（年数）呈显著趋势。按肿瘤的解剖位置分离后，在男性和女性中，曾吸烟者患贲门癌的风险（HR = 2.86; 95%CI 1.66-4.93）高于远端胃癌（HR = 1.52; 95%CI 1.25-1.86）。组织学肿瘤类型分析显示，目前吸烟与肠道类型之间存在更强的关联。总体而言，本研究显示，目前吸烟与男女胃癌之间存在关联，这种效应在五个种族中具有一致性，有证据表明吸烟在男女中存在剂量反应效应，对贲门癌的影响强于远端胃癌，并且与肠型胃癌的相关性强于弥漫型胃癌。
The purpose of this study is to investigate the association of cigarette smoking with gastric cancer.Over 215,000 men and women, representing five ethnic groups (African Americans, Japanese Americans, Latino Americans, Native Hawaiians, and Whites), completed a mailed questionnaire, 1993-1996. After an average follow-up of 7.3 years, 454 men and 242 women were diagnosed with gastric adenocarcinoma. Cox proportional hazard models were used to calculate multivariate-adjusted hazard ratios and 95% confidence intervals.Current cigarette smokers had elevated hazard ratios compared with never smokers among men (HR = 1.98; 95% CI 1.46-2.70) and women (HR = 1.78; 95% CI 1.23-2.57). This positive association was consistent across all five ethnicities. Former smokers had an elevated risk among men, but not among women. There was a significant trend by intensity (cigarettes per day) and duration (years) of smoking among all current smokers. After separation by anatomic location of their tumor, ever smokers had a higher risk for gastric cardia cancer (HR = 2.86; 95% CI 1.66-4.93) than for distal gastric cancer (HR = 1.52; 95% CI 1.25-1.86) among men and women combined. Analysis by histologic tumor type showed a stronger association between current smoking and the intestinal type.Overall, this study shows an association of current cigarette smoking with gastric cancer in both sexes, consistency of this effect across five ethnic groups, evidence for a dose-response effect of smoking in both sexes, a stronger effect for cardia than for distal gastric cancer, and a stronger association for intestinal than for diffuse gastric cancer.