Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies.

Abstract

Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.

• Authors: Beate Pesch, Benjamin Kendzia, Per Gustavsson, Karl-Heinz Jöckel, Georg Johnen, Hermann Pohlabeln, Ann Olsson, Wolfgang Ahrens, Isabelle Mercedes Gross, Irene Brüske, Heinz-Erich Wichmann, Franco Merletti, Lorenzo Richiardi, Lorenzo Simonato, Cristina Fortes, Jack Siemiatycki, Marie-Elise Parent, Dario Consonni, Maria Teresa Landi, Neil Caporaso, David Zaridze, Adrian Cassidy, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Isabelle Stücker, Eleonora Fabianova, Rodica Stanescu Dumitru, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Charles M Rudin, Paul Brennan, Paolo Boffetta, Kurt Straif, Thomas Brüning
• Journal: International journal of cancer (Int J Cancer) Vol. 131 Issue 5 Pg. 1210-9 (Sep 01 2012) ISSN: 1097-0215 [Electronic] United States
• PMID: 22052329 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 UICC.

Topics

• Adenocarcinoma (epidemiology, etiology, pathology)
• Adolescent
• Adult
• Canada (epidemiology)
• Carcinoma, Squamous Cell (epidemiology, etiology, pathology)
• Case-Control Studies
• Child
• Europe (epidemiology)
• Female
• Humans
• Lung Neoplasms (epidemiology, etiology, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prevalence
• Prognosis
• Risk
• Small Cell Lung Carcinoma (epidemiology, etiology, pathology)
• Smoking (adverse effects)
• Young Adult