title: Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe.
abstract: 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.
authors.affiliation: Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain. a.agudo@ico.scs.es
authors.forename: A
authors.initials: A
authors.lastname: Agudo
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.forename: E
authors.initials: E
authors.lastname: Benhamou
authors.forename: S
authors.initials: S
authors.lastname: Benhamou
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
authors.forename: S C
authors.initials: SC
authors.lastname: Darby
authors.forename: F
authors.initials: F
authors.lastname: Forastiere
authors.forename: C
authors.initials: C
authors.lastname: Fortes
authors.forename: V
authors.initials: V
authors.lastname: Gaborieau
authors.forename: C A
authors.initials: CA
authors.lastname: González
authors.forename: K H
authors.initials: KH
authors.lastname: Jöckel
authors.forename: M
authors.initials: M
authors.lastname: Kreuzer
authors.forename: F
authors.initials: F
authors.lastname: Merletti
authors.forename: H
authors.initials: H
authors.lastname: Pohlabeln
authors.forename: L
authors.initials: L
authors.lastname: Richiardi
authors.forename: E
authors.initials: E
authors.lastname: Whitley
authors.forename: H E
authors.initials: HE
authors.lastname: Wichmann
authors.forename: P
authors.initials: P
authors.lastname: Zambon
authors.forename: L
authors.initials: L
authors.lastname: Simonato
mesh_terms: 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