Gender and Histologic Type Variations in Smoking-Related Risk of Lung Cancer

Brownson, Ross C.; Chang, Jincai; Davis, James R.

doi:10.1097/00001648-199201000-00012

Cited by 174 publications

(105 citation statements)

References 27 publications

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“…[12][13][14][15][16][17][18][19][20][21][27][28][29][30][31][32][33][34][35][36] The magnitude of relative risk in Japan ranged from 3.7-5.1 for all histologic types combined, either from cohort or case-control studies. When divided by histologic type, findings from a case-control study indicated that odds ratios ranged from 4.3-21.4 for squamous cell and small cell carcinoma and from 1.5-3.7 for adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Sobue

Yamamoto

Hara

et al. 2002

Intl Journal of Cancer

142

116

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In order to update the findings of relative risk associated with cigarette smoking for lung cancer by histologic type in Japan, the data from a population-based cohort study of 91,738 men and women were analyzed. During 1990 -1999, 422 lung cancer incident cases were identified. The relative risk for all incident cases associated with current smokers versus non-smokers was 4.5 [95% confidence interval (CI): 3.0 -6.8] and 4.2 (95% CI: 2.4 -7.2), for men and women, respectively. When divided by histologic type, relative risk for squamous cell carcinoma and small cell carcinoma was 12.7 (95% CI: 4.7-34.7) and 17.5 (95% CI: 4.9 -62.1), while for adenocarcinoma it was 2.8 (95% CI: 1.6 -4.9) and 2.0 (95% CI: 0.8 -5.0) for men and women, respectively. We confirmed that the lung cancer risk in men rose with increasing cigarette smoking, especially the duration of smoking among current smokers and decreased after the cessation of smoking among former smokers. Unlike the US or European countries, the relative risk did not increase in this updated study, compared with previous studies in 1960s to 1990s in Japan either for all incident cases or for specific histologic types and the magnitude of relative risks was substantially lower than that observed in the US or European countries, especially for adenocarcinoma. © 2002 Wiley-Liss, Inc. Key words: lung cancer; histologic type; cigarette smoking; relative riskRecent trends in lung cancer incidence showed a relative increase in adenocarcinoma as compared with squamous cell carcinoma for both men and women in various countries. [1][2][3][4][5][6] It is hypothesized that this trend is mainly due to the dissemination of low-tar filter cigarettes, 7-9 since filters mainly remove the larger particles in cigarette smoke, which tend to be deposited in the central large bronchus where most squamous cell carcinomas arise. However, such filters do not remove smaller particles, which tend to reach the peripheral region of the lung where adenocarcinomas arise. Moreover, in order to compensate for nicotine intake, smokers of low-tar filter cigarettes tend to inhale more deeply than those of nonfilter cigarettes, which results in more cigarette smoke reaching the peripheral region. Switching from nonfilter to filter cigarettes occurred mostly during in the US, the UK and Japan, where market share of filtered cigarette exceeded that of nonfilter cigarette in 1959, 1967 and 1965, respectively. 10,11 In the US and European countries, this hypothesis is supported by the finding that the magnitude of the relative risk of lung adenocarcinoma associated with cigarette smoking increased in recent studies, just when the usage of low-tar filter cigarette became more widespread among study subjects. It is reported from the US that the risk of lung adenocarcinoma is many times higher for current smokers than non-smokers, i.e., 19.0-fold for men and 8.1-fold for women in the Cancer Prevention Study (CPS) II (1982II ( -1984, while in CPS I (1959 -1961) corresponding estimates were 4.6 and 1.5 for me...

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Section: Discussionmentioning

confidence: 99%

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Sobue

Yamamoto

Hara

et al. 2002

Intl Journal of Cancer

142

116

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“…Female smokers have been found to have a higher risk of lung cancer compared to males for similar levels of tobacco exposure [41][42][43][44] and it has been suggested that estrogen-related effects may partly explain the gender difference in smoking-associated risk of lung cancer. Estrogens are known to be involved in fetal lung differentiation 45 and experimental work using immunohistochemical techniques indicates the presence of estrogen and other steroid receptors in lung tissue, [45][46][47] including a high proportion (98%) of non-small cell lung cancers.…”

Section: Discussionmentioning

confidence: 99%

Diet, reproductive factors and lung cancer risk among Chinese women in Singapore: Evidence for a protective effect of soy in nonsmokers

Seow

Poh

Teh

et al. 2001

Intl Journal of Cancer

104

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The factors associated with risk of lung cancer among nonsmokers have not been fully elucidated, but dietary factors have consistently been shown to play a role. Chinese women are unique in having a high incidence of lung cancer despite a low smoking prevalence. This population is also known to have a high intake of soy, a dietary source of phytoestrogens. We conducted a hospital-based case-control study among Singapore Chinese women, comprising 303 cases and 765 age-matched controls, of whom 176 cases and 663 controls were lifetime nonsmokers. Data on demographic background, reproductive factors and dietary intake of fruit, vegetables and soy foods were obtained by in-person interview. We observed an inverse association between intake of total, cruciferous and non-cruciferous vegetables and risk of lung cancer among smokers. Although smokers in the highest tertile of fruit intake also had a lower risk, this was not statistically significant. Higher intake of soy foods significantly reduced risk of lung cancer among lifetime nonsmokers, but not among smokers. When soy isoflavonoid intake in mg/week was computed based on frequency and portion size of intake of eight common local soy foods, the adjusted OR among nonsmokers for the highest tertile compared to the lowest was 0.56, 95% CI 0.37-0.85 (p for trend <0.01). Fruit intake was also significantly associated with reduced lung cancer risk among nonsmokers, but the effect was not significant after adjustment for soy intake. On the other hand, soy intake remained an independent predictor of risk after controlling for fruit intake. Reproductive effects were also primarily confined to lifetime nonsmokers, among whom having 3 or more livebirths (adjusted OR 0.65, 0.44 -0.96) and a menstrual cycle length of more than 30 days (OR 0.46, 0.25-0.84) accorded a significantly reduced risk of lung cancer. Place of birth was significantly associated with risk among nonsmokers (OR 2.6, 1.7-3.9 for China-born vs. local born) but not among smokers. When analysis was restricted to nonsmokers with adenocarcinomas, the dietary effects were consistent or enhanced. On stepwise regression, soy intake and cycle length emerged as the independent dietary and reproductive predictors of lung cancer risk in nonsmokers. These findings are consistent with other evidence suggesting an involvement of estrogen-related pathways in lung cancer among non-smoking women.

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“…At least ten case -control studies have reported that women who smoke have a higher relative risk of developing lung cancer from smoking than do male smokers (Brownson et al, 1992;Cohn et al, 1996;Harris et al, 1993;Lubin and Blot, 1984;Mcduffie et al, 1991;Osann et al, 1993;Prescott et al, 1998;Risch et al, 1993;Wynder, 1992, 1996). Other studies have reported a similar gender difference for cancers of the urinary bladder (Castelao et al, 2001) and esophagus Gammon et al, 1997).…”

Section: Lung Cancer Risk In Women Versus Menmentioning

confidence: 99%

Tobacco use and cancer: an epidemiologic perspective for geneticists

2002

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Much of what is known about the deleterious effects of tobacco use on health was learned from epidemiologic studies over the last half century. These studies establish unequivocally that tobacco use, particularly manufactured cigarette smoking, causes most cancers of the lung, oropharynx, larynx, and esophagus in the USA, and approximately one-third of all cancers of the pancreas, kidney, urinary bladder and uterine cervix. More recent evidence also implicates smoking with cancers of the stomach, liver and colorectum. While over half of the estimated 440 000 smoking-attributable deaths that occur annually in the USA involve non-malignant cardiovascular and respiratory conditions, smoking-attributable cancers are more recognized and feared. Geneticists increasingly study tobacco use as a model for environmental carcinogenicity. Tobacco-exposed populations provide opportunities to characterize the somatic mutations that give rise to specific cancers and to identify the inherited genetic traits that confer susceptibility or resistance. Studies to identify the genetic determinants of addiction may be particularly important. Future research to identify other susceptibility factors, such as genes that modify carcinogen metabolism or DNA repair, will need to be substantially larger and to quantify lifetime tobacco exposure with more precision than have past studies in order to distinguish gradations in risk due to exposure from those caused by genetic susceptibility. This review considers: (a) the epidemiology of tobacco use; (b) cancers presently classified as smoking-attributable by the US Surgeon General; (c) the magnitude of the epidemic of cancers and other diseases caused by tobacco use; (d) selected issues in the epidemiology of lung cancer; and (e) the interface of genetics and epidemiology in understanding, preventing, and treating tobacco-attributable disease.

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Gender and Histologic Type Variations in Smoking-Related Risk of Lung Cancer

Cited by 174 publications

References 27 publications

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Diet, reproductive factors and lung cancer risk among Chinese women in Singapore: Evidence for a protective effect of soy in nonsmokers

Tobacco use and cancer: an epidemiologic perspective for geneticists

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