Risk of lung cancer among women in relation to lifetime history of tobacco smoking: a population-based case-control study in France (the WELCA study)

BMC Cancer

Martine Antoine¹  Marie Wislez²  Hélène Blons³  Pierre Laurent-Puig³  Jean Trédaniel⁴  Nastassia Tvardik⁵  Isabelle Stücker⁵  Régine Billmann⁵  Jennifer Rusmaully⁵  Diane Martin⁵  Sylvie Cénée⁵  Pascal Guénel⁵  Loredana Radoï⁶ 

[1] AP-HP, Tenon Hospital, Pathology, 4 rue de la Chine, Paris, France;UPMC Univ Paris 06, GRC No.04, Theranoscan, Paris, France;AP-HP.Centre - Université de Paris, Hôpital Cochin, Unité d’Oncologie Thoracique, Service de Pneumologie, Paris, France;Centre de Recherche des Cordeliers, Université de Paris, UMRS 1138 « Complement, Inflammation and Cancer », Paris, France;Assistance Publique Hôpitaux de Paris, Paris Cancer Institute CARPEM, AP-HP.Centre - Université de Paris, Department of Biology Physiology and Genetics, Hopital Européen Georges Pompidou, Paris, France;Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France;Groupe Hospitalier Paris Saint Joseph, Université de Paris, Unité INSERM UMR-S 1124, Toxicologie, pharmacologie et signalisation cellulaire, Paris, France;Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France;Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France;AP-HP Nord - Université de Paris, Hôpital Louis Mourier, UFR d’odontologie, Paris, France;

关键词: Epidemiology;    Lung cancer;    Histology;    Women;    Tobacco;    Smoking patterns;    Cigarette dependence;   

DOI  :  10.1186/s12885-021-08433-z

来源: Springer

【 摘 要 】

BackgroundThis study aims to provide new insights on the role of smoking patterns and cigarette dependence in female lung cancer, and to examine differences by histological subtype.MethodsWe conducted a population-based case-control study in the great Paris area among women including 716 incident cases diagnosed between 2014 and 2017 and 757 age-matched controls. Detailed data on smoking history was collected during in-person interviews to assess intensity and duration of tobacco smoking, time since cessation, smoking habits (depth of smoke inhalation, use of filter, type of tobacco, and type of cigarettes) and Fagerström test for cigarette dependence. The comprehensive smoking index (CSI), a score modelling the combined effects of intensity, duration and time since quitting smoking was determined for each subject. Multivariable logistic regression models were fitted to calculate odds ratios (ORs) and their confidence intervals (95%CI) of lung cancer associated with smoking variables.ResultsLung cancer risk increased linearly with intensity and duration of tobacco smoking while it decreased with time since cessation, to reach the risk in never-smokers after 20 years of abstinence. The combined effect of intensity and duration of tobacco smoking was more than multiplicative (p-interaction 0.012). The OR in the highest vs the lowest quartile of CSI was 12.64 (95%CI 8.50; 18.80) (p-trend < 0.001). The risk of small cell or squamous cell carcinomas increased with the CSI more sharply than the risk of adenocarcinomas. Deep smoke inhalation, dark vs blond tobacco, conventional vs light cigarettes, and unfiltered vs filtered cigarettes, as well as having mixed smoking habits, were found to be independent risk factors. Having high cigarette addiction behaviours also increased the risk after adjusting for CSI.ConclusionThis study provides additional insights on the effects of tobacco smoking patterns on lung cancer risk among women.

【 授权许可】

CC BY