Publication details

Cigarette smoking and lung cancerurelative risk estimates for the major histological types from a pooled analysis of case-control studies

Authors	PESCH Beate KENDZIA Benjamin GUSTAVSSON Per JOECKEL Karl-Heinz JOHNEN Georg POHLABELN Hermann OLSSON Ann AHRENS Wolfgang GROSS Isabelle Mercedes BRUESKE Irene WICHMANN Heinz-Erich MERLETTI Franco RICHIARDI Lorenzo SIMONATO Lorenzo FORTES Cristina SIEMIATYCKI Jack PARENT Marie-Elise CONSONNI Dario LANDI Maria Teresa CAPORASO Neil ZARIDZE David CASSIDY Adrian SZESZENIA-DABROWSKA Neonila RUDNAI Peter LISSOWSKA Jolanta STUECKER Isabelle FABIANOVA Eleonora DUMITRU Rodica Stanescu BENCKO Vladimír FORETOVÁ Lenka JANOUT Vladimír RUDIN Charles M BRENNAN Paul BOFFETTA Paolo STRAIF Kurt BRUENING Thomas
Year of publication	2012
Type	Article in Periodical
Magazine / Source	International journal of cancer
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1002/ijc.27339
Field	Oncology and hematology
Keywords	cigarette smoking; lung cancer; relative risk characterization; tobacco smoke; stem cells
Description	Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8143.2) for SqCC, 111.3 (95% CI: 69.8177.5) for SCLC and 21.9 (95% CI: 16.629.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5124.6), 108.6 (95% CI: 50.7232.8) and 16.8 (95% CI: 9.230.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.