Dose-response Relationships Between Cigarette Smoking and Breast Cancer Risk: A Systematic Review and Meta-analysis

Scala, Marco; Bosetti, Cristina; Bagnardi, Vincenzo; Possenti, Irene; Specchia, Claudia; Gallus, Silvano; Lugo, Alessandra

doi:10.2188/jea.je20220206

Cited by 9 publications

(5 citation statements)

References 40 publications

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“…In conclusion, this longitudinal study confirms the inverse association between active smoking and MBD, probably due to the anti-estrogenic effects of tobacco smoking. However, cigarette smoking was recently defined as a risk factor for BC ( 5 , 6 ), therefore suggesting that the causal biological pathway linking smoking and BC not includes MBD but is probably due to the carcinogenic effects of constituents in tobacco smoke on the breast tissue. Given the important anti-estrogenic effect on MBD and the established carcinogenic effect on breast tissue, it would be interesting to evaluate, in future studies, the effect of the inclusion of information on smoking habits during the lifespan as additional parameter in the main existing BC risk prediction models.…”

Section: Discussionmentioning

confidence: 99%

“…In the 2012 monograph 100E on Personal Habits and Indoor Combustions, the International Agency for Research on Cancer (IARC) concluded that there was a direct association between tobacco smoking and female BC risk ( 5 ). Subsequently, a recent review and meta-analysis conducted on the basis of 169 studies, provided further evidence of the causal role of tobacco smoke on the risk of BC, with an increased risk of 7%, 8% and 9% respectively in current smokers, former smokers and ever smokers, compared to non-smokers ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Cigarette smoking and mammographic breast density in post-menopausal women from the EPIC Florence cohort

Bendinelli,

Caini,

Assedi

et al. 2024

Front. Oncol.

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IntroductionCigarette smoking has been recognized as a risk factor for breast cancer (BC) also if the biological mechanism remains poorly understood. High mammographic breast density (MBD) is associated with BC risk and many BC risk factors, such as genetic, anthropometric, reproductive and lifestyle factors and age, are also able to modulate MBD. The aim of the present study was to prospectively explore, in post-menopausal women, the association between smoking habits and MBD, assessed using an automated software, considering duration and intensity of smoking.MethodsThe analysis was carried out in 3,774 women enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) Florence cohort in 1993-98, participating in the 2004-06 follow up (FU) and with at least one full-field digital mammography (FFDM) performed after FU. For each woman, detailed information on smoking habits, anthropometry, lifestyle and reproductive history was collected at enrollment and at FU. Smoking information at baseline and at FU was integrated. The fully automated Volpara™ software was used to obtain total breast volume (cm3), absolute breast dense volume (DV, cm3) and volumetric percent density (VPD, %) from the first available FFDM (average 5.3 years from FU). Multivariable linear regression models were applied to evaluate the associations between smoking habits and VPD or DV.ResultsAn inverse association between smoking exposure and VPD emerged (Diff% -7.96%, p <0.0001 for current smokers and -3.92%, p 0.01 for former smokers, compared with non-smokers). An inverse dose-response relationship with number of cigarettes/day, years of smoking duration and lifetime smoking exposure (pack-years) and a direct association with time since smoking cessation among former smokers emerged. Similar associations, with an attenuated effect, emerged when DV was considered as the outcome variable.DiscussionThis longitudinal study confirms the inverse association between active smoking, a known risk factor for BC, and MBD among post-menopausal women. The inclusion of smoking habits in the existing BC risk prediction models could be evaluated in future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cigarette smoking and mammographic breast density in post-menopausal women from the EPIC Florence cohort

Bendinelli,

Caini,

Assedi

et al. 2024

Front. Oncol.

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“…A number of studies have also con rmed that smoking can increase the risk of female breast cancer and is a controllable risk factor for female breast cancer [12][13][14] . Lai et al found that current smoking status was signi cantly associated with an increased risk of overall and cancer-speci c death in women with breast cancer [15] .…”

Section: Discussionmentioning

confidence: 99%

The effect of smoking on breast cancer screening results in female population:a study in Wu wei, China

Sun,

Hu,

et al. 2024

Preprint

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Objective To construct a pathway analysis model of breast cancer screening population in this region based on Anderson model theory, and explore the influencing factors and pathways of screening results of breast cancer screening population in this region, in order to provide reference for refining breast cancer screening strategies and programs. Methods Firstly, the distribution of each variable in the detection of breast related diseases was described by single factor analysis, and then a pathway analysis model for screening results of female breast cancer screening population in 2021-2023 was constructed according to the results of factor screening, so as to clarify the influence path and influence coefficient of each factor. Results A total of 1792 female residents participated in breast cancer screening between 2021 and 2023, and 353 were detected with breast related diseases, with a detection rate of 19.7%. Single factor analysis showed that: Exposure to harmful substances, age, highest education, marital status, family history of breast cancer, menopause, weekly intake of fresh vegetables and fruits, weekly intake of processed foods, weekly intake of meat, eggs and milk, taste preference, preferred food or drink temperature, smoking, alcohol consumption, regular physical exercise, history of breast biopsy or breast benign Variables such as history of surgery and history of chest radiotherapy were different in whether breast related disease was detected. The result of path analysis model shows that the overall model fits well. The most significant variable of propensity characteristic dimension is the highest education; The significant variable in the dimension of medical behavior was smoking. The path coefficient indicates that the female population with lower education and smoking is more likely to detect mamma-related lesions in the screening population. In addition to the direct effect, the highest degree of education also had an indirect effect on whether breast related lesions were detected in the female screening population through the mediating variable of smoking. Conclusion The results of this study confirm the importance of a healthy lifestyle. We should further strengthen the publicity and education on smoking cessation, and persuade smokers, especially pay attention to the promotion of smoking cessation behavior in the female population with low education level.

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“…Notably, our selection of diseases, although conservative, still accounts for a substantial proportion, approximately 85%, of the global deaths attributed to tobacco smoking as calculated by the Global Burden of Disease Study 26 , suggesting that we have captured a substantial, albeit not wholly exhaustive, proportion of the total hospitalizations attributable to smoking. Despite this, our analysis did not encompass several common and costly diseases that have been demonstrated to be linked to smoking, such as breast and colorectal cancer 21 , 27 , 28 , which stand as the two most frequently diagnosed cancers in Italy 29 . We also did not include diabetes, prostate cancer, and liver cancer, all established to be linked with smoking 21 .…”

Section: Discussionmentioning

confidence: 99%

Analysis of the direct economic impact of smoking-related hospitalizations in Italy

Possenti,

Scala,

Rognoni

et al. 2024

Tob. Induc. Dis.

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INTRODUCTION Tobacco-related diseases have a substantial economic impact in terms of medical expenses, loss of productivity, and premature death. Tobacco use is estimated to be responsible for more than 90000 deaths each year in Italy. We aimed to evaluate the annual direct economic impact on the National Health System of hospitalizations attributable to tobacco smoking in Italy. METHODS We analyzed data from all the hospitalizations of patients aged ≥30 years that occurred in Italy for 12 selected tobacco-related diseases, during 2018. These diseases included oropharyngeal cancer, esophageal cancer, gastric cancer, lung cancer, pancreatic cancer, bladder cancer, laryngeal cancer, ischemic heart disease, stroke, diseases of arteries, arterioles, and capillaries, pneumonia and influenza, and chronic obstructive pulmonary disease. We obtained information on 984322 hospital discharge records, including each hospitalization's direct costs. Using relative risk estimates from the scientific literature, we computed the population attributable fraction for various tobacco-related diseases to estimate the economic impact attributable to tobacco smoking. RESULTS One-third of all hospitalizations occurred in 2018 in Italy among people aged ≥30 years for 12 tobacco-related diseases were found to be attributable to smoking, accounting for a total cost of €1.64 billion. Among the diseases considered, those with the highest expenditures attributable to tobacco smoking were ischemic heart disease, cerebrovascular disease, and lung cancer, accounting for €556 million, €290 million, and €229 million, respectively. CONCLUSIONS Tobacco has a substantial economic impact in Italy, accounting for around 6% of the total cost of hospitalizations in 2018. This figure is expected to be largely underestimated due to several conservative assumptions adopted in the statistical analyses. It is imperative to prioritize comprehensive tobacco control measures to counteract the huge healthcare costs due to tobacco smoking.

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Dose-response Relationships Between Cigarette Smoking and Breast Cancer Risk: A Systematic Review and Meta-analysis

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record.

Cited by 9 publications

References 40 publications

Cigarette smoking and mammographic breast density in post-menopausal women from the EPIC Florence cohort

Cigarette smoking and mammographic breast density in post-menopausal women from the EPIC Florence cohort

The effect of smoking on breast cancer screening results in female population:a study in Wu wei, China

Analysis of the direct economic impact of smoking-related hospitalizations in Italy

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