title: Heavy smoking and lung cancer: are women at higher risk? Result of the ICARE study.
abstract: BACKGROUND
  Whether women are more or equally susceptible to the carcinogenic effects of cigarette smoke on the lungs compared with men is a matter of controversy. Using a large French population-based case-control study, we compared the lung cancer risk associated with cigarette smoking by gender.
  
  
  METHODS
  The study included 2276 male and 650 female cases and 2780 male and 775 female controls. Lifetime smoking exposure was represented by the comprehensive smoking index (CSI), which combines the duration, intensity and time since cessation of smoking habits. The analysis was conducted among the ever smokers. All of the models were adjusted for age, department (a regional administrative unit), education and occupational exposures.
  
  
  RESULTS
  Overall, we found that the lung cancer risk was similar among men and women. However, we found that women had a two-fold greater risk associated with a one-unit increase in CSI than men of developing either small cell carcinoma (OR=15.9, 95% confidence interval (95% CI) 7.6, 33.3 and 6.6, 95% CI 5.1, 8.5, respectively; P<0.05) or squamous cell carcinoma (OR=13.1, 95% CI 6.3, 27.3 and 6.1, 95% CI 5.0, 7.3, respectively; P<0.05). The association was similar between men and women for adenocarcinoma.
  
  
  CONCLUSIONS
  Our findings suggest that heavy smoking might confer to women a higher risk of lung cancer as compared with men.
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université Paris Sud 11, UMRS 1018, 94807 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Papadopoulos
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université Paris Sud 11, UMRS 1018, 94807 Villejuif, France.
authors.forename: F
authors.initials: F
authors.lastname: Guida
authors.affiliation: Université Bordeaux Segalen, Inserm U897, 33076 Bordeaux, France.
authors.forename: K
authors.initials: K
authors.lastname: Leffondré
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université Paris Sud 11, UMRS 1018, 94807 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Cénée
authors.affiliation: Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Cyr
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Schmaus
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: L
authors.initials: L
authors.lastname: Radoï
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Paget-Bailly
authors.affiliation: Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: M
authors.initials: M
authors.lastname: Carton
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: G
authors.initials: G
authors.lastname: Menvielle
authors.affiliation: Registre des tumeurs du Doubs et du Territoire de Belfort, CHU Saint Jacques, Besançon, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Woronoff
authors.affiliation: Registre des cancers de l'Hérault, Montpellier, France.
authors.forename: B
authors.initials: B
authors.lastname: Tretarre
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université de Versailles St-Quentin, UMRS 1018, 94807 Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Luce
authors.affiliation: 1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université Paris Sud 11, UMRS 1018, 94807 Villejuif, France.
authors.forename: I
authors.initials: I
authors.lastname: Stücker
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*