[Tobacco smoke and malignant tumors. Analysis by birth cohorts from 1875 to 1935].
Over the last decades, the relationship between tobacco smoking and cancer has been studied utilizing all the models available to research. The epidemiological researches, that are carried out on human populations, constitute the study model which can provide definitive evidence on the considered association. Among the several cancer sites, cancer of the lung, oral cavity and pharynx, esophagus, larynx, pancreas and urinary bladder are the sites more directly related with smoking habits. In this research the relationship between these cancer sites and tobacco smoking was studied examining both the international literature, and applying the cohort analysis to Italian mortality data from 1950 to 1983. The birth cohorts considered were those from 1875 to 1935 and data on cancer deaths are derived from official ISTAT publications. The analysis of cohort variation was carried out utilizing the indirect standardization method. The data on tobacco consumption, from 1900 to 1985, was obtained from official publication of the Administration of the State Monopolies or from unpublished material kindly provided by the same Administration. Regarding lung cancer, literature data emphasize the relationship between the disease frequency and age of starting smoking and the type of tobacco smoked. In Italy cohort variation seems to indicate an increased risk in mortality for men born before 1925, but there are indications of levelling off after this year. Analysis of the consumption of different types of tobacco products since 1900 suggests that the trends of mortality with time in different birth cohorts are explicable in terms of changes in the use of cigarettes, with high tar content up to 1940-1950, with low tar content and filter tipped after the 50s. Regarding females from the cohort variation it can be inferred that in Italy women began to smoke more recently and tobacco consumption is referred, almost exclusively, to low-tar and filter-tipped cigarettes. For larynx cancer, the literature data report that the relative risk is related to smoking habits and the present analysis shows a cohort variation very similar to that for lung cancer. Smoking habits, alcohol consumption, and their interaction, constitute the principal risk factor both for esophagus cancer and that of oral cavity and pharynx. In Italy the risk derived from alcohol consumption has influenced the trends of cohort variation relative to these two sites, which contrary to lung and larynx cohort trends, shows some fluctuations in mortality in males before 1921 and a progressive increase after this year. The relationship relative to urinary bladder and pancreas cancer is less evident.(ABSTRACT TRUNCATED AT 400 WORDS)
La Rosa
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Iannacci
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Trotta
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D003043:Cocarcinogenesis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology
Fumo di tabacco e tumori maligni. Analisi per coorti di nascita dal 1875 al 1935.