title: [Synergistic effects of different types of smoking and other risk factors on risk of hepatocellular carcinoma in Xiamen, China].
abstract: OBJECTIVE
  To evaluated the independent effects of different types of smoking exposure along with multiple risk factors for hepatocellular carcinoma (HCC) and determined whether the magnitude of smoking was modified by other risk factors, both in men and women.
  
  
  METHODS
  We conducted a case-control study in Xiamen China. 345 HCC patients and 961 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor.
  
  
  RESULTS
  Cigars and pipes were not related to HCC among non-cigarette smokers. However, passive smoking exposure was associated with HCC in women: AOR, 2.35 (95%CI: 1.19 - 4.07). Regular cigarette smoking was associated with HCC in men: AOR, 2.27 (95%CI: 1.14 - 3.31). Cigarette smoking and chronic infection of hepatitis B virus showed positive additive model interactions in men: RERI (relative excess risk due to interaction) was 98.70 and AP (attributable proportion due to interactions) was 81.0%. Data on cigarette smoking with high AFB1-albumin adducts in women showed that the RERI was 2.69 and AP was 50.0%.
  
  
  CONCLUSIONS
  We concluded that sex differences were seen in HCC relationship with cigarette smoking. Controlling of exposure to smoking might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections.
authors.affiliation: Xiamen City Center for Disease Control and Prevention, Xiamen 361021, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Niu
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Su
authors.forename: Yao-Feng
authors.initials: YF
authors.lastname: Han
authors.forename: Ran
authors.initials: R
authors.lastname: Zhao
authors.forename: Xue-Li
authors.initials: XL
authors.lastname: Sun
authors.forename: Fei
authors.initials: F
authors.lastname: Guo
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Ben-Hua
authors.initials: BH
authors.lastname: Zhao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000821:virology; D016022:Case-Control Studies; D002681:China; D006801:Humans; D008113:Liver Neoplasms / Q000821:virology; D012307:Risk Factors; D012907:Smoking