Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium

BMC Medicine

Research Article

Martin Bobak¹  Bas Bueno-de-Mesquita²  Tom Wilsgaard³  Catherine E. de Keyser⁴  Albert Hofman⁴  Rikje Ruiter⁴  Bruno H. Stricker⁴  Stefan Söderberg⁵  Anne Tjønneland⁶  Ute Mons⁷  Lisette CPGM de Groot⁸  Ellen Kampman⁸  Michail Katsoulis⁹  Paolo Boffetta^1,10  Antonia Trichopoulou^1,11  Abdonas Tamosiunas^1,12  Alicja Wolk^1,13  Nicola Orsini^1,13  Niclas Håkansson^1,13  Sofia Malyutina^1,14  Mazda Jenab^1,15  Heinz Freisling^1,15  Andrzej Pająk^1,16  Pekka Jousilahti^1,17  Kari Kuulasmaa^1,17  Růžena Kubínová^1,18  José Manuel Ordóñez-Mena^1,19  Ben Schöttker^1,19  Hermann Brenner^2,20  Neal D. Freedman^2,21  Lena Maria Nilsson^2,22  Frank Kee^2,23  Angela Scott^2,23  Mark G. O’Doherty^2,23  Philippos Orfanos^2,24 

[1] Department Epidemiology and Public Health, University College London, London, UK;Department of Chronic Diseases, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands;Division of Epidemiology and Biostatistics, the School of Public Health, Imperial College London, London, United Kingdom;Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway;Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Public Health and Clinical Medicine, Cardiology, and Heart Center, Umeå University, Umeå, Sweden;Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany;Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands;Hellenic Health Foundation, Athens, Greece;Hellenic Health Foundation, Athens, Greece;Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Hellenic Health Foundation, Athens, Greece;University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, Athens, Greece;Institute of Cardiology of Lithuanian University of Health Sciences, Kaunas, Lithuania;Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;Institute of Internal and Preventive Medicine, Novosibirsk, Russia;International Agency for Research on Cancer (IARC), Lyon, France;Jagiellonian University Medical College, Faculty of Health Sciences, Krakow, Poland;National Institute for Health and Welfare (THL), Helsinki, Finland;National Institute of Public Health, Prague, Czech Republic;Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany;Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany;German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany;Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany;Nutritional Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA;Nutritional Research, Department of Public Health and Clinical Medicine, and Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden;UKCRC Centre of Excellence for Public Health, Queens University of Belfast, Belfast, UK;University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, Athens, Greece;

关键词: Smoking;    Cancer;    Incidence;    Mortality;    Cohort;    Meta-analysis;   

DOI  :  10.1186/s12916-016-0607-5

 received in 2016-01-30, accepted in 2016-03-18,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSmoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality.MethodsThis is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs.ResultsOverall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking.ConclusionsThis investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.

【 授权许可】

CC BY   
© Ordóñez-Mena et al. 2016