Risk of lung cancer from tobacco smoking among young women from Europeписьмо
Аннотация: Since the late 1960s, the prevalence of smoking among European women has sharply increased, and lung cancer rates in women have recently shown a parallel increase. Rates among young women are now nearly equal between men and women in the Scandinavian countries.1 In many developed countries, prevalence of tobacco smoking is now higher in young women than in young men.2 Although previous studies have identified tobacco smoking as an important risk factor of lung cancer among young women,3, 4 the rarity of lung cancer in this group hampered a detailed assessment of the quantitative aspects of tobacco smoking, in particular among women aged less than 40 or even less than 35. Within the frame of a pooled analysis of case-control studies of tobacco smoking and lung cancer conducted in Western Europe between 1991 and 1994, we identified 116 female cases of lung cancer and 175 age-matched controls under the age of 45. These subjects were recruited from 2 centres in Germany (46 cases and 43 controls), 1 in Spain (14 and 27) and one in France (56 and 105). Detailed information was collected on the history of tobacco smoking. Control subjects were selected from patients admitted to the same hospitals as the cases for disease not related to tobacco smoking (in Spain and France) or from a random sample of residents of the study areas (in Germany). The cases and controls from the German centres were included in previous analyses.4, 5 We calculated the odds ratios of lung cancer and their 95% confidence intervals (CIs) based on multivariate logistic regression, after adjusting for centre and single year of age, and stratifying by 5-year age groups. Among women aged less than 40 and in particular among those aged less than 35, the carcinogenic effect of tobacco smoking, albeit present, was weaker than among those aged 40 or more (Table I). This pattern held true for ever-smokers, current smokers and ex-smokers, and across categories of comparable duration of smoking, cumulative tobacco consumption and average daily consumption of cigarettes. None of the differences in results among age-groups, however, was statistically significant; for example, the p-value of interaction terms between age-group and cumulative consumption were 0.5 (<35 vs. 35–39) and 0.25 (35–39 vs. 40–44). Cases with small cell carcinoma represented 34% of total cases, whereas adenocarcinoma and squamous cell carcinoma comprised 23% and 12% of total cases: the distribution by histological type was similar in the 3 age groups shown in the table. The fraction of lung cancer cases attributable to ever smoking was 0.54 (95% CI 0.11–0.97) among women below age 35, 0.58 (95% CI 0.26–0.90) among women aged 35–39, and 0.84 (95% CI 0.72–0.96) among women aged 40–44. Our results suggest a smaller role of tobacco smoking in lung carcinogenesis in very young women as compared to other women, that is not explained by a lower consumption of tobacco in the former group. The difference might be due to the fact that latency in very young women was inadequate to completely observe the carcinogenic effect of tobacco smoking. Alternatively, defence mechanisms against tobacco carcinogens might be stronger during early adulthood as compared to later in life. A different role of genetic susceptibility could also be involved, as suggested also by the higher proportion of never smokers among cases in the young age groups (4/15, 8/35 and 6/66 respectively). Given the long latency of the carcinogenic action of tobacco smoke, however, our results do not support the notion that smoking tobacco early in life poses a lower long-term carcinogenic risk than smoking later in life.
Год издания: 2001
Авторы: Paolo Boffetta, Michaela Kreuzer, Simone Benhamou, Antonio Agudo, H-Erich Wichmann, Valérie Gaborieau, Lorenzo Simonato, Paolo Boffetta, Michaela Kreuzer, Simone Benhamou, Antonio Agudo, H.‐Erich Wichmann, Valérie Gaborieau, Lorenzo Simonato
Издательство: Wiley
Источник: International Journal of Cancer
Ключевые слова: Cancer Risks and Factors
Другие ссылки: International Journal of Cancer (PDF)
International Journal of Cancer (HTML)
PubMed (HTML)
International Journal of Cancer (HTML)
PubMed (HTML)
Открытый доступ: bronze
Том: 91
Выпуск: 5
Страницы: 745–746