title: Gender susceptibility for cigarette smoking-attributable lung cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  As the primary cause of lung cancer, whether smoking confers the same risk of lung cancer for women as men is unclear. Therefore, we aimed to compare male and female susceptibility for cigarette smoking-attributable lung cancer.
  
  
  METHODS
  A systematic review and meta-analysis was conducted by searching articles published up to July 2013 in three online databases (MEDLINE, EMBASE, and Cochrane Database). All studies estimated the association of cigarette smoking with the risk of lung cancer between men and women, respectively. A random effects model with inverse variance weighting was used to pool data. Male to female ratio of relative risk (RRR) was calculated to compare male and female susceptibility for cigarette smoking-attributable lung cancer.
  
  
  RESULTS
  47 articles containing 404,874 individuals were included in the final analysis. Compared with non-smokers, male to female RRR was 1.61 (95%CI: 1.37, 1.89) among current smokers. Based on pathological type, adenocarcinoma had the highest RRR (1.42; 95%CI: 0.86, 2.35), followed by squamous cancer and small cell lung cancer. Furthermore, compared with non-smoking men, current smoking men had higher risk of lung cancer than women in spite of smoking quantity, smoking duration or years since quitting.
  
  
  CONCLUSIONS
  These findings indicated that males had higher susceptibility for cigarette smoking-attributable lung cancer than females. It is contradicted with traditional opinion that females would be more easily suffered from cigarette smoking-attributable health problems than males. Hence, tobacco control is very crucial in both males and females.
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Yunxian
authors: Y
authors: Yu
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Hui
authors: H
authors: Liu
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Shuangshuang
authors: S
authors: Zheng
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Zheyuan
authors: Z
authors: Ding
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Zexin
authors: Z
authors: Chen
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Wen
authors: W
authors: Jin
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Lijuan
authors: L
authors: Wang
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Zhaopin
authors: Z
authors: Wang
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Ying
authors: Y
authors: Fei
authors: Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China; Chronic Disease Research Institute, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China.
authors: Shanchun
authors: S
authors: Zhang
authors: Department of Respiratory Medicine, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou 310016, China.
authors: Kejing
authors: K
authors: Ying
authors: Department of Respiratory Medicine, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou 310016, China. Electronic address: tougaoing2014@163.com.
authors: Ruifeng
authors: R
authors: Zhang
mesh_terms: D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D016017:Odds Ratio; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*
keywords: Cigarette smoking; Gender susceptibility; Lung cancer; Meta-analysis; Ratio of relative risk; Systematic review