Hemminki Kari, Chen Bowang
Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Int J Cancer. 2006 Feb 1;118(3):744-8. doi: 10.1002/ijc.21387.
The carcinogenic effects of active smoking have been demonstrated for many sites, but the effects of passive smoking and exposures during pregnancy and breastfeeding are less well documented. We examined whether 0-70-year-old offspring of parents with lung cancer are at a risk of cancer that cannot be explained by their smoking or familial risk. It was assumed that known target sites for tobacco carcinogenesis would be affected, if any. The nationwide Swedish Family-Cancer Database with cancers recorded from 1958 to 2002 was used to calculate age-specific standardized incidence ratios (SIRs). Among offspring of affected mothers, increased risks were observed for upper aerodigestive (SIR 1.45), nasal (2.93), lung (1.71) and bladder (1.52) cancers and for kidney cancer (6.41) in one age group. The risk of bladder cancer was found in younger age groups than that of lung cancer. Cancers at many of these sites, but not the kidney or the bladder, were in excess in offspring of affected fathers. Nasal cancer was even increased when either parent was diagnosed with lung cancer; the highest risk was for nasal adenoid cystic carcinoma (7.73). The data suggest that passive smoking during childhood is associated with an increase risk of nasal cancer. For bladder and kidney cancers, a contribution by tobacco carcinogens is implicated through breastfeeding and in utero exposure.
主动吸烟的致癌作用已在许多部位得到证实，但被动吸烟以及孕期和哺乳期暴露的影响记录较少。我们研究了肺癌患者的0至70岁子女是否存在无法用其吸烟情况或家族风险来解释的癌症风险。假定如果存在影响的话，已知的烟草致癌靶部位会受到影响。利用记录了1958年至2002年癌症情况的瑞典全国性家庭癌症数据库来计算年龄特异性标准化发病比（SIR）。在受影响母亲的子女中，观察到上呼吸消化道（SIR 1.45）、鼻腔（2.93）、肺（1.71）和膀胱（1.52）癌以及一个年龄组的肾癌（6.41）风险增加。发现膀胱癌的风险在较年轻年龄组中比肺癌更高。在受影响父亲的子女中，这些部位中的许多部位（但不包括肾或膀胱）的癌症发病率过高。当父母任何一方被诊断为肺癌时，鼻腔癌甚至会增加；风险最高的是鼻腺样囊性癌（7.73）。数据表明儿童期被动吸烟与鼻腔癌风险增加有关。对于膀胱癌和肾癌，烟草致癌物通过母乳喂养和子宫内暴露有一定作用。
