Cigarette smoking and cancer risk:: Modeling total exposure and intensity
Cigarette smoking and cancer risk:: Modeling total exposure and intensity
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DOI：
10.1093/aje/kwm089
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发表时间：
2007-08-15
影响因子：
5
通讯作者：
Zielinski, Jan M.
中科院分区：
文献类型：
--
作者：
Lubin, Jay H.;Alavanja, Michael C. R.;Zielinski, Jan M.
最近的一项分析表明，吸烟引起的肺癌的超额比值比 (EOR) 可以通过一个函数来建模，该函数与总吸烟年数呈线性关系，而与吸烟强度的对数及其平方呈指数关系。每天低于 15-20 支卷烟时，每包年的 EOR 随着强度（直接暴露率或增强效力效应）而增加，这表明以较高强度（较短持续时间）进行总暴露的风险比以较低强度进行同等暴露的风险更大。每天超过 20 支卷烟，每包年的 EOR 随着强度的增加而下降（反向暴露率或效力降低效应），这表明以较低强度（较长持续时间）进行总暴露的风险比以较高强度进行同等暴露的风险更大。作者将该模型应用于 10 项癌症病例对照研究的数据，包括肺癌、膀胱癌、口腔癌、胰腺癌和食道癌。在较低强度下，对几个癌症部位的效力增强，但包年的狭窄范围增加了不确定性，排除了明确的结论。在较高强度下，各项研究中均出现了一致的效力降低效果。强度效应在统计上是同质的，这表明在考虑了总包年的风险后，不同癌症部位的强度模式具有可比性。
A recent analysis showed that the excess odds ratio (EOR) for lung cancer due to smoking can be modeled by a function which is linear in total pack-years and exponential in the logarithm of smoking intensity and its square. Below 15-20 cigarettes per day, the EOR/pack-year increased with intensity (direct exposure rate or enhanced potency effect), suggesting greater risk for a total exposure delivered at higher intensity (for a shorter duration) than for an equivalent exposure delivered at lower intensity. Above 20 cigarettes per day, the EOR/pack-year decreased with increasing intensity (inverse exposure rate or reduced potency effect), suggesting greater risk for a total exposure delivered at lower intensity (for a longer duration) than for an equivalent exposure delivered at higher intensity. The authors applied this model to data from 10 case-control studies of cancer, including cancers of the lung, bladder, oral cavity, pancreas, and esophagus. At lower intensities, there was enhanced potency for several cancer sites, but narrow ranges for pack-years increased uncertainty, precluding definitive conclusions. At higher intensities, there was a consistent reduced potency effect across studies. The intensity effects were statistically homogeneous, indicating that after accounting for risk from total pack-years, intensity patterns were comparable across the diverse cancer sites.