title: Associated Links Among Smoking, Chronic Obstructive Pulmonary Disease, and Small Cell Lung Cancer: A Pooled Analysis in the International Lung Cancer Consortium.
abstract: BACKGROUND
  The high relapse and mortality rate of small-cell lung cancer (SCLC) fuels the need for epidemiologic study to aid in its prevention.
  
  
  METHODS
  We included 24 studies from the ILCCO collaboration. Random-effects panel logistic regression and cubic spline regression were used to estimate the effects of smoking behaviors on SCLC risk and explore their non-linearity. Further, we explored whether the risk of smoking on SCLC was mediated through COPD.
  
  
  RESULTS
  Significant dose-response relationships of SCLC risk were observed for all quantitative smoking variables. Smoking pack-years were associated with a sharper increase of SCLC risk for pack-years ranged 0 to approximately 50. The former smokers with longer cessation showed a 43%quit_for_5-9 years to 89%quit_for_≥ 20 years declined SCLC risk vs. subjects who had quit smoking < 5 years. Compared with non-COPD subjects, smoking behaviors showed a significantly higher effect on SCLC risk among COPD subjects, and further, COPD patients showed a 1.86-fold higher risk of SCLC. Furthermore, smoking behaviors on SCLC risk were significantly mediated through COPD which accounted for 0.70% to 7.55% of total effects.
  
  
  CONCLUSIONS
  This is the largest pooling study that provides improved understanding of smoking on SCLC, and further demonstrates a causal pathway through COPD that warrants further experimental study.
authors: Ruyi
authors: R
authors: Huang
authors: Yongyue
authors: Y
authors: Wei
authors: Rayjean J
authors: RJ
authors: Hung
authors: Geoffrey
authors: G
authors: Liu
authors: Li
authors: L
authors: Su
authors: Ruyang
authors: R
authors: Zhang
authors: Xuchen
authors: X
authors: Zong
authors: Zuo-Feng
authors: ZF
authors: Zhang
authors: Hal
authors: H
authors: Morgenstern
authors: Irene
authors: I
authors: Brüske
authors: Joachim
authors: J
authors: Heinrich
authors: Yun-Chul
authors: YC
authors: Hong
authors: Jin Hee
authors: JH
authors: Kim
authors: Michele
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authors: Cote
authors: Angela
authors: A
authors: Wenzlaff
authors: Ann G
authors: AG
authors: Schwartz
authors: Isabelle
authors: I
authors: Stucker
authors: John
authors: J
authors: Mclaughlin
authors: Michael W
authors: MW
authors: Marcus
authors: Michael P A
authors: MP
authors: Davies
authors: Triantafillos
authors: T
authors: Liloglou
authors: John K
authors: JK
authors: Field
authors: Keitaro
authors: K
authors: Matsuo
authors: Matt
authors: M
authors: Barnett
authors: Mark
authors: M
authors: Thornquist
authors: Gary
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authors: Goodman
authors: Yi
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authors: Wang
authors: Size
authors: S
authors: Chen
authors: Ping
authors: P
authors: Yang
authors: Eric J
authors: EJ
authors: Duell
authors: Angeline S
authors: AS
authors: Andrew
authors: Philip
authors: P
authors: Lazarus
authors: Joshua
authors: J
authors: Muscat
authors: Penella
authors: P
authors: Woll
authors: Janet
authors: J
authors: Horsman
authors: M Dawn
authors: MD
authors: Teare
authors: Anath
authors: A
authors: Flugelman
authors: Gad
authors: G
authors: Rennert
authors: Yan
authors: Y
authors: Zhang
authors: Hermann
authors: H
authors: Brenner
authors: Christa
authors: C
authors: Stegmaier
authors: Erik H F M
authors: EH
authors: van der Heijden
authors: Katja
authors: K
authors: Aben
authors: Lambertus
authors: L
authors: Kiemeney
authors: Juan
authors: J
authors: Barros-Dios
authors: Monica
authors: M
authors: Pérez-Ríos
authors: Alberto
authors: A
authors: Ruano-Ravina
authors: Neil E
authors: NE
authors: Caporaso
authors: Pier Alberto
authors: PA
authors: Bertazzi
authors: Maria Teresa
authors: MT
authors: Landi
authors: Juncheng
authors: J
authors: Dai
authors: Hongbing
authors: H
authors: Hongbing Shen
authors: Guillermo
authors: G
authors: Fernandez-Tardon
authors: Marta
authors: M
authors: Rodriguez-Suarez
authors: Adonina
authors: A
authors: Tardon
authors: David C
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authors: Christiani
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D016017:Odds Ratio; D011159:Population Surveillance; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012306:Risk; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology* / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors