Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe.
The association between cigarette smoking and lung cancer risk in women was investigated within the framework of a case-control study in 9 centres from 6 European countries. Cases were 1,556 women up to 75 years of age with histologically confirmed primary lung cancer; 2, 450 controls with age distribution similar to cases were selected. The predominant cell type was adenocarcinoma (33.5%), with similar proportions for squamous-cell type (26.4%) and small-cell carcinoma (22.3%). Overall, smoking cigarettes at any time was associated with a 5-fold increase in lung cancer risk (odds ratio 5.21, 95% confidence interval 4.49-6.04); corresponding figures for current smoking habits were 8.94, 7.54-10.6. The association showed a dose-response relationship with duration of the habit and daily and cumulative lifetime smoking. A significant excess risk of 70% was associated with every 10 pack-years smoked. After 10 years of smoking cessation, the relative risk decreased to 20% compared to current smokers. The following characteristics were associated with a higher relative risk: inhalation of smoke, smoking non-filter cigarettes, smoking dark-type cigarettes and starting at young age. The association was observed for all major histological types, being the strongest for small-cell type carcinoma, followed by squamous-cell type and the lowest for adenocarcinoma. The proportion of lung-cancer cases in the population attributable to cigarette smoking ranged from 14% to 85%. We concluded that women share most features of the association between cigarette smoking and lung cancer observed in men.
Agudo
A
A
Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain. a.agudo@ico.scs.es
Ahrens
W
W
Benhamou
E
E
Benhamou
S
S
Boffetta
P
P
Darby
S C
SC
Forastiere
F
F
Fortes
C
C
Gaborieau
V
V
González
C A
CA
Jöckel
K H
KH
Kreuzer
M
M
Merletti
F
F
Pohlabeln
H
H
Richiardi
L
L
Whitley
E
E
Wichmann
H E
HE
Zambon
P
P
Simonato
L
L
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016387:Women's Health