Active and passive smoking in relation to lung cancer incidence in the Women's Health Initiative prospective cohort study.

1504 Background: The relationship between both active and passive smoking and lung cancer incidence in post-menopausal women was examined in theWomen’s Health Initiative Observational Study (WHI-OS). Methods: The WHI-OS, a prospective cohort study conducted at 40 U.S. centers, enrolled women ages 50-79 from 1993-1998.Among 93,676 participants, 76,304 women with complete smoking and covariate data comprised the analytic cohort, in which the association of lung cancer incidence with active and passive (childhood, adult home, and work) smoking exposure was studied. Results: Over 10.5 meanyears of follow-up with 901 lung cancer cases, lung cancer incidence was higher in current smokers (HR 13.44, 95% CI 10.80-16.75) and former smokers (HR 4.20, 95% CI 3.48-5.08), compared to never smokers. This relationship was dose-dependent for both current and former smokers. Risk of all lung cancer subtypes, particularly small cell lung cancer (SCLC) and squamous cell carcinoma (SqCC), was higher in smokers. Among never smokers, any passive smoking exposure (HR 0.88, 95% CI 0.52-1.49) and most passive smoking categories did not significantly increase lung cancer risk, compared to no passive exposure; however, passive exposure as an adult at home for >=30 years was associated with increased risk, of borderline significance (HR 1.61, 95% CI 1.00-2.58). Current smokers had an annualized lung cancer incidence rate of 472.9 cases/100,000 person-years, compared to 158.1 for former smokers and 36.2 for never smokers (112.3 overall). Conclusions: To our knowledge, this is the first study to examine both active and passive smoking in relation to lung cancer incidence in a complete prospective cohort of U.S. women. Active smoking is associated with significant increases in incidence of all lung cancer subtypes in post-menopausal women, particularly SCLC and SqCC. Smoking cessation decreases lung cancer risk. Prolonged exposure as an adult at home may be the strongest passive smoking contributor to lung cancer risk in this cohort. The findings support continued need for investment in smoking prevention and cessation, research on passive smoking, and understanding of lung cancer risk factors other than smoking.

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Lung Cancer Risk Reduction After Smoking Cessation: Observations From a Prospective Cohort of Women

Journal of Clinical Oncology ◽

10.1200/jco.2003.05.085 ◽

2003 ◽

Vol 21 (5) ◽

pp. 921-926 ◽

Cited By ~ 118

Author(s):

J.O. Ebbert ◽

P. Yang ◽

C.M. Vachon ◽

R.A. Vierkant ◽

J.R. Cerhan ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Risk ◽

Risk Reduction ◽

Prospective Cohort ◽

Lung Cancer Risk ◽

Smoking History ◽

Cox Regression Analysis ◽

Former Smokers ◽

Never Smokers

Purpose: We conducted this study because the duration of excess lung cancer risk among former smokers has been inconsistently reported, doubt has been raised regarding the population impact of smoking cessation, and differential risk reduction by histologic cell type after smoking cessation needs to be confirmed. Methods: The Iowa Women’s Health Study is a prospective cohort study of 41,836 Iowa women aged 55 to 69 years. In 1986, mailed questionnaires were used to collect detailed smoking history. Age-adjusted lung cancer incidence through 1999 was analyzed according to years of smoking abstinence. Relative risks were estimated using Cox regression analysis. Results: There were 37,078 women in the analytic cohort. Compared with the never smokers, former smokers had an elevated lung cancer risk (relative risk, 6.6; 95% confidence interval, 5.0 to 8.7) up to 30 years after smoking cessation for all former smokers. However, a beneficial effect of smoking cessation was observed among recent and distant former smokers. The risk of adenocarcinoma remained elevated up to 30 years for both former heavier and former lighter smokers. Conclusion: The risk for lung cancer is increased for both current and former smokers compared with never smokers and declines for former smokers with increasing duration of abstinence. The decline in excess lung cancer risk among former smokers is prolonged compared with other studies, especially for adenocarcinoma and for heavy smokers, suggesting that more emphasis should be placed on smoking prevention and lung cancer chemoprevention.

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White Blood Cell Count and Risk of Incident Lung Cancer in the UK Biobank

JNCI Cancer Spectrum ◽

10.1093/jncics/pkz102 ◽

2019 ◽

Vol 4 (2) ◽

Author(s):

Jason Y Y Wong ◽

Bryan A Bassig ◽

Erikka Loftfield ◽

Wei Hu ◽

Neal D Freedman ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Blood Cell ◽

White Blood Cell ◽

Lung Cancer Risk ◽

Uk Biobank ◽

Former Smokers ◽

Never Smokers ◽

The Uk ◽

Incident Cases

Abstract Background The contribution of measurable immunological and inflammatory parameters to lung cancer development remains unclear, particularly among never smokers. We investigated the relationship between total and differential white blood cell (WBC) counts and incident lung cancer risk overall and among subgroups defined by smoking status and sex in the United Kingdom (UK). Methods We evaluated 424 407 adults aged 37–73 years from the UK Biobank. Questionnaires, physical measurements, and blood were administered and collected at baseline in 2006–2010. Complete blood cell counts were measured using standard methods. Lung cancer diagnoses and histological classifications were obtained from cancer registries. Multivariable Cox regression models were used to estimate the hazard ratio (HR) and 95% confidence intervals of incident lung cancer in relation to quartiles (Q) of total WBC and subtype-specific counts, with Q1 as the reference. Results There were 1493 incident cases diagnosed over an average 7-year follow-up. Overall, the highest quartile of total WBC count was statistically significantly associated with elevated lung cancer risk (HRQ4 = 1.67, 95% CI = 1.41 to 1.98). Among women, increased risks were found in current smokers (ncases / n = 244 / 19 464, HRQ4 = 2.15, 95% CI = 1.46 to 3.16), former smokers (ncases / n = 280 / 69 198, HRQ4 = 1.75, 95% CI = 1.24 to 2.47), and never smokers without environmental tobacco smoke exposure (ncases / n = 108 / 111 294, HRQ4 = 1.93, 95% CI = 1.11 to 3.35). Among men, stronger associations were identified in current smokers (ncase s / n = 329 / 22 934, HRQ4 = 2.95, 95% CI = 2.04 to 4.26) and former smokers (ncases / n = 358/71 616, HRQ4 = 2.38, 95% CI = 1.74 to 3.27) but not in never smokers. Findings were similar for lung adenocarcinoma and squamous cell carcinoma and were driven primarily by elevated neutrophil fractions. Conclusions Elevated WBCs could potentially be one of many important markers for increased lung cancer risk, especially among never-smoking women and ever-smoking men.

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Passive Smoking and Lung Cancer Association: A Result of Bias?

Human Toxicology ◽

10.1177/096032718700600612 ◽

1987 ◽

Vol 6 (6) ◽

pp. 517-524 ◽

Cited By ~ 45

Author(s):

P.N. Lee

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Passive Smoking ◽

Lung Cancer Risk ◽

Smoking Habit ◽

Epidemiological Studies ◽

The Other ◽

Smoking Habits ◽

Self Reports ◽

Never Smokers

1 Epidemiological studies have reported that non-smokers married to smokers have a lung cancer risk 20-50% higher than that of non-smokers married to non-smokers. 2 In contrast, extrapolation based on relative smoke exposure of passive and active smokers would predict a much smaller effect. 3 This paper examines the possibility that bias due to misclassification of smoking habits, coupled with between spouse smoking habit concordance, could account for this discrepancy. 4 One thousand seven hundred and seventy-five subjects were asked about their smoking habits and use of other nicotine products in a non-health context likely to minimize underreporting of smoking. One thousand five hundred and thirty-seven provided saliva for cotinine analysis. Of 808 who claimed not to be users of such products, 2.5% had cotinine values above 30 ng/ml, suggesting their self reports were false. In another study 540 subjects were interviewed in 1980 and in 1985. Ten per cent claiming on one occasion never to have smoked, made inconsistent statements on the other occasion. A third study showed a strong tendency for smokers to marry smokers. 5 Estimates of bias based on these data indicate that misclassification can explain the unexpectedly high lung cancer risk associated with spouse smoking in epidemiological studies of self-reported never smokers.

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Active and passive smoking in relation to lung cancer incidence in the Women's Health Initiative Observational Study prospective cohort

Annals of Oncology ◽

10.1093/annonc/mdu470 ◽

2015 ◽

Vol 26 (1) ◽

pp. 221-230 ◽

Cited By ~ 20

Author(s):

A. Wang ◽

J. Kubo ◽

J. Luo ◽

M. Desai ◽

H. Hedlin ◽

...

Keyword(s):

Lung Cancer ◽

Observational Study ◽

Women's Health ◽

Cancer Incidence ◽

Passive Smoking ◽

Prospective Cohort ◽

Lung Cancer Incidence ◽

Women's Health Initiative ◽

Health Initiative ◽

The Women’S Health Initiative

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Metformin Use and Lung Cancer Risk in Diabetic Patients: A Systematic Review and Meta-Analysis

Disease Markers ◽

10.1155/2019/6230162 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 8

Author(s):

Long Yao ◽

Mengke Liu ◽

Yunlong Huang ◽

Kaiming Wu ◽

Xin Huang ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Cohort Studies ◽

Cancer Incidence ◽

Lung Cancer Risk ◽

Meta Analysis ◽

Diabetic Patients ◽

Lung Cancer Incidence ◽

Lower Lung ◽

The Relationship

Background. Antidiabetic medications (ADMs) can alter the risk of different types of cancer, but the relationship between lung cancer incidence and metformin remains controversial. Our aim was to quantitatively estimate the relationship between incidences of lung cancer and metformin in patients with diabetes in this meta-analysis. Methods. We performed a search in PubMed, Embase, ISI Web of Science, and Cochrane Library until September 20, 2017. The odds ratio (OR), relative risk (RR) or hazard ratio (HR), and 95% confidence interval (95% CI) were estimated using the random-effect model. The Newcastle-Ottawa Scale (NOS) was used to assess the study quality. Results. A total of 13 studies (10 cohort studies and 3 case-control studies) were included in the meta-analysis. Compared to nonmetformin users, metformin probably decreased lung cancer incidence in diabetic patients (RR=0.89; 95% CI, 0.83-0.96; P=0.002) with significant heterogeneity (Q=35.47, I2=66%, P=0.0004). Subgroup analysis showed that cohort studies (RR=0.91; 95% CI, 0.85-0.98; P=0.008), location in Europe (RR=0.90; 95% CI, 0.86-0.94; P<0.0001), the control drug of the sulfonylurea group (RR=0.91; 95% CI, 0.86-0.96; P=0.001), and adjusting for smoking (RR=0.86; 95% CI, 0.75-1.00; P=0.05) may be related to lower lung cancer risk. No significant publication bias was detected using a funnel plot. Conclusion. Metformin use was related to a lower lung cancer risk in diabetic patients compared to nonusers, but this result was retrieved from observational studies and our findings need more well-designed RCTs to confirm the association.

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Associations between Biomarkers of Exposure and Lung Cancer Risk among Exclusive Cigarette Smokers in the Golestan Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147349 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7349

Author(s):

Brian L. Rostron ◽

Jia Wang ◽

Arash Etemadi ◽

Sapna Thakur ◽

Joanne T. Chang ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Cancer Risk ◽

Cancer Incidence ◽

Lung Cancer Risk ◽

Disease Risk ◽

Geometric Mean ◽

Lung Cancer Incidence ◽

Cigarette Smokers ◽

Opium Use

Biomarkers of tobacco exposure are known to be associated with disease risk but previous studies are limited in number and restricted to certain regions. We conducted a nested case–control study examining baseline levels and subsequent lung cancer incidence among current male exclusive cigarette smokers in the Golestan Cohort Study in Iran. We calculated geometric mean biomarker concentrations for 28 matched cases and 52 controls for the correlation of biomarker levels among controls and for adjusted odds’ ratios (ORs) for lung cancer incidence by biomarker concentration, accounting for demographic characteristics, smoking quantity and duration, and opium use. Lung cancer cases had higher average levels of most biomarkers including total nicotine equivalents (TNE-2), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and 3-hydroxyfluorene (3-FLU). Many biomarkers correlated highly with one another including TNE-2 with NNAL and N-Acetyl-S-(2-cyanoethyl)-L-cysteine (2CYEMA), and N-Acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine (t4HBEMA) with N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (3HMPMA) and N-Acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (4HMBEMA). Lung cancer risk increased with concentration for several biomarkers, including TNE-2 (OR = 2.22, 95% CI = 1.03, 4.78) and NNN (OR = 2.44, 95% CI = 1.13, 5.27), and estimates were significant after further adjustment for demographic and smoking characteristics for 2CYEMA (OR = 2.17, 95% CI = 1.03, 4.55), N-Acetyl-S-(2-carbamoylethyl)-L-cysteine (2CAEMA) (OR = 2.14, 95% CI = 1.01, 4.55), and N-Acetyl-S-(2-hydroxypropyl)-L-cysteine (2HPMA) (OR = 2.85, 95% CI = 1.04, 7.81). Estimates were not significant with adjustment for opium use. Concentrations of many biomarkers were higher at the baseline for participants who subsequently developed lung cancer than among the matched controls. Odds of lung cancer were higher for several biomarkers including with adjustment for smoking exposure for some but not with adjustment for opium use.

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LUNG CANCER INCIDENCE AND CANCER RISK FROM RADIOACTIVITY – SOME DATA FOR THE CAPITAL OF MONTENEGRO

RAP 2019 Conference Proceedings ◽

10.37392/rapproc.2019.17 ◽

2020 ◽

Author(s):

Danko Živković ◽

Nevenka M. Antović

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Cancer Incidence ◽

Lung Cancer Incidence

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Cancer of the Lung, Larynx, and Pleura

10.1093/oso/9780190676827.003.0014 ◽

2018 ◽

Author(s):

Jyoti Malhotra ◽

Paolo Boffetta ◽

Lorelei Mucci

Keyword(s):

Lung Cancer ◽

Secondhand Smoke ◽

Lung Cancer Risk ◽

Occupational Exposures ◽

Men And Women ◽

Established Risk Factor ◽

Former Smokers ◽

Never Smokers ◽

Exposure To Secondhand Smoke ◽

Cancer Of The Lung

Lung cancer is the most commonly diagnosed cancer among men in most countries, and is the primary cause of cancer death in men and women. Its epidemic increase in incidence began in the first half of the twentieth century, paralleling the uptake of cigarette smoking that occurred 20 years before. A series of landmark studies beginning in 1950 established tobacco as the primary cause of lung cancer. Current smokers have a 10- to 20-fold higher lung cancer risk compared to never smokers. Important for prevention, former smokers substantially reduce this excess risk 5 years after smoking cessation. Exposure to secondhand smoke, a well-established risk factor for lung cancer, has a 20%–25% higher risk for those exposed. There are several occupational exposures associated with lung cancer, including asbestos. Despite the success in defining lung cancer’s etiology, this highly preventable disease remains among the most common and most lethal cancers globally.

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