Wakai Kenji, Inoue Manami, Mizoue Tetsuya, Tanaka Keitaro, Tsuji Ichiro, Nagata Chisato, Tsugane Shoichiro
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
Jpn J Clin Oncol. 2006 May;36(5):309-24. doi: 10.1093/jjco/hyl025. Epub 2006 May 30.
Although tobacco smoking is the best established risk factor for lung cancer, the association is not as strong among Japanese as among Western populations. It would be of value, therefore, to quantify that association in Japan based on a systematic review of epidemiological evidence for the primary prevention of lung cancer.
Original data were obtained from MEDLINE searches using PubMed, supplemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of the association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer. A meta-analysis was also conducted to estimate the summary measure of those associations.
A total of 8 cohort studies and 14 case-control studies were identified, almost all of which consistently showed a strong association of current smoking with the risk of lung cancer. The summary relative risk for current smokers versus never smokers was estimated as 4.39 (95% confidence interval 3.92-4.92) for men and 2.79 (95% confidence interval 2.44-3.20) for women. Cohort studies and case-control studies gave reasonably consistent summary measures. The summary relative risks were 11.7 and 2.30 for squamous cell carcinoma and adenocarcinoma, respectively, in men, and were 11.3 and 1.37 correspondingly in women.
There is convincing evidence that tobacco smoking strongly increases the risk of lung cancer in the Japanese population, with the relative risk for current smokers compared with never smokers measuring around 4.4 for men and 2.8 for women.
尽管吸烟是肺癌最明确的风险因素，但在日本人群中，这种关联不如在西方人群中那么强烈。因此，基于对肺癌一级预防的流行病学证据进行系统综述，在日本对这种关联进行量化将具有重要意义。
原始数据通过使用PubMed在MEDLINE中检索获得，并辅以手工检索。关联评估基于证据强度、关联程度以及国际癌症研究机构先前评估的生物学合理性。还进行了荟萃分析以估计这些关联的汇总指标。
共识别出8项队列研究和14项病例对照研究，几乎所有研究都一致显示当前吸烟与肺癌风险之间存在强烈关联。男性当前吸烟者与从不吸烟者的汇总相对风险估计为4.39（95%置信区间3.92 - 4.92），女性为2.79（95%置信区间2.44 - 3.20）。队列研究和病例对照研究给出了相当一致的汇总指标。男性鳞状细胞癌和腺癌的汇总相对风险分别为11.7和2.30，女性相应为11.3和1.37。
有令人信服的证据表明，吸烟会显著增加日本人群患肺癌的风险，当前吸烟者与从不吸烟者相比，男性的相对风险约为4.4，女性约为2.8。
