Epplein Meira, Schwartz Stephen M, Potter John D, Weiss Noel S
Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, M4-B402, P.O. Box 19024, Seattle, WA 98109-1024, USA.
Cancer Causes Control. 2005 Nov;16(9):1085-90. doi: 10.1007/s10552-005-0330-6.
Chinese women residing in Asia and Hawaii have low consumption of tobacco but a high incidence of lung cancer. To explore this question further, we conducted a study of lung cancer among Chinese women residing in mainland US.
Using data from NCI's SEER program, we identified residents of Los Angeles County, the San Francisco Metropolitan Area, and the Seattle-Puget Sound Area who were 50 years or older, diagnosed with cancer of the lung or bronchus in 1999-2001, with race specified as non-Hispanic white (n = 18,493), Chinese (n = 853), Filipino (n = 615), or Japanese (n = 282). The sex-specific observed number of lung cancer cases among each Asian sub-group was compared to the expected number of lung cancer cases for each Asian sub-group. The expected number was determined by multiplying the age-, sex-, and geographic area-adjusted incidence rates for non-Hispanic whites by the age- and sex-specific ratio of percentage of current smokers in each Asian sub-group to whites in 1990, and then by the size of the respective Asian populations.
Chinese women had a four-fold increased risk of lung cancer, and Filipino women a two-fold increased risk, compared to that expected based on rates in US non-Hispanic whites with a similar proportion of cigarette smokers. Lung cancer among Chinese, Filipino, and Japanese males, as well as Japanese females, did not deviate from expected risk. Among Chinese women, the increased risk was largely restricted to adenocarcinoma and large cell undifferentiated carcinoma.
Chinese female residents of the western US mainland have a much higher risk of lung cancer than would be predicted from their tobacco use patterns, just as they do in Asia.
居住在亚洲和夏威夷的中国女性烟草消费量较低，但肺癌发病率较高。为进一步探究这一问题，我们对居住在美国大陆的中国女性肺癌情况进行了一项研究。
利用美国国立癌症研究所（NCI）监测、流行病学和最终结果（SEER）项目的数据，我们确定了洛杉矶县、旧金山大都市区和西雅图-普吉特海湾地区50岁及以上的居民，这些居民在1999 - 2001年被诊断患有肺癌或支气管癌，种族指定为非西班牙裔白人（n = 18493）、中国人（n = 853）、菲律宾人（n = 615）或日本人（n = 282）。将每个亚洲亚组中按性别观察到的肺癌病例数与每个亚洲亚组肺癌病例的预期数进行比较。预期数的确定方法是，将非西班牙裔白人的年龄、性别和地理区域调整后的发病率，乘以1990年每个亚洲亚组当前吸烟者与白人的年龄和性别特定百分比比例，然后乘以相应亚洲人群的规模。
与吸烟比例相似的美国非西班牙裔白人相比，中国女性患肺癌的风险增加了四倍，菲律宾女性增加了两倍。中国、菲律宾和日本男性以及日本女性的肺癌风险与预期风险没有偏差。在中国女性中，风险增加主要限于腺癌和大细胞未分化癌。
美国大陆西部的中国女性居民患肺癌的风险比根据其吸烟模式预测的要高得多，与她们在亚洲的情况一样。
