吸烟与男性和女性膀癌风险之间的关联
Neal D Freedman1, Debra T Silverman, Albert R Hollenbeck
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 6120 Executive Blvd, EPS/320, MSC 7232, Rockville, MD 20852, USA. freedmanne@mail.nih.gov
JAMA
|August 18, 2011
概括
吸烟显著增加了膀癌的风险,目前的吸烟者面临的风险是从未吸烟者的四倍以上. 由于吸烟导致的膀癌的风险在男性和女性中都是相当大的.
科学领域:
- 流行病学 流行病学
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 烟草吸烟是膀癌的主要风险因素,之前的估计表明男性的50-65%的人口可归因风险 (PAR) 和女性的20-30%.
- 与从未吸烟相比,目前的香烟吸烟使膀癌的风险增加了三倍.
- 30年来美国的稳定发病率需要重新评估与吸烟有关的风险,因为吸烟模式和香烟成分发生了变化.
研究的目的:
- 评估烟草吸烟与膀癌之间的关联.
- 在当代队列中更新吸烟和膀癌的风险估计.
主要方法:
- 前性队列研究 (国家卫生研究院-AARP饮食和健康研究) 包括281,394名男性和186,134名女性.
- 参与者填写了生活方式问卷;从1995年到2006年进行了随访.
- 使用固定效应模型,对先前的队列研究进行系统审查和对相对风险的元分析.
主要成果:
- 在超过450万人年的随访中,发生的膀癌发生在3896名男性和627名女性中.
- 与从未吸烟者相比,目前吸烟者患膀癌的风险增加了4.06倍 (HR=4.06).
- 人口可归因的吸烟风险在男性中为0.50,在女性中为0.52,与早期研究相比,在这个队列中观察到的相对风险更高.
结论:
- 最近的NIH-AARP队列中,吸烟和膀癌的相对风险比1963-1987年美国数据相比更高.
- 与吸烟相关的膀癌的风险在这个队列中的男性和女性之间是可比的.
- 这些发现强调了吸烟对膀癌症风险的持续显著影响.
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