title: Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies.
abstract: Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.
authors: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr Universität Bochum (IPA), Bochum, Germany. pesch@ipa-dguv.de
authors: Beate
authors: B
authors: Pesch
authors: Benjamin
authors: B
authors: Kendzia
authors: Per
authors: P
authors: Gustavsson
authors: Karl-Heinz
authors: KH
authors: Jöckel
authors: Georg
authors: G
authors: Johnen
authors: Hermann
authors: H
authors: Pohlabeln
authors: Ann
authors: A
authors: Olsson
authors: Wolfgang
authors: W
authors: Ahrens
authors: Isabelle Mercedes
authors: IM
authors: Gross
authors: Irene
authors: I
authors: Brüske
authors: Heinz-Erich
authors: HE
authors: Wichmann
authors: Franco
authors: F
authors: Merletti
authors: Lorenzo
authors: L
authors: Richiardi
authors: Lorenzo
authors: L
authors: Simonato
authors: Cristina
authors: C
authors: Fortes
authors: Jack
authors: J
authors: Siemiatycki
authors: Marie-Elise
authors: ME
authors: Parent
authors: Dario
authors: D
authors: Consonni
authors: Maria Teresa
authors: MT
authors: Landi
authors: Neil
authors: N
authors: Caporaso
authors: David
authors: D
authors: Zaridze
authors: Adrian
authors: A
authors: Cassidy
authors: Neonila
authors: N
authors: Szeszenia-Dabrowska
authors: Peter
authors: P
authors: Rudnai
authors: Jolanta
authors: J
authors: Lissowska
authors: Isabelle
authors: I
authors: Stücker
authors: Eleonora
authors: E
authors: Fabianova
authors: Rodica Stanescu
authors: RS
authors: Dumitru
authors: Vladimir
authors: V
authors: Bencko
authors: Lenka
authors: L
authors: Foretova
authors: Vladimir
authors: V
authors: Janout
authors: Charles M
authors: CM
authors: Rudin
authors: Paul
authors: P
authors: Brennan
authors: Paolo
authors: P
authors: Boffetta
authors: Kurt
authors: K
authors: Straif
authors: Thomas
authors: T
authors: Brüning
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D012306:Risk; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012907:Smoking / Q000009:adverse effects*; D055815:Young Adult