Bjerregaard Bine Kjøller, Raaschou-Nielsen Ole, Sørensen Mette, Frederiksen Kirsten, Christensen Jane, Tjønneland Anne, Overvad Kim, Chapelon Francoise Clavel, Nagel Gabriele, Chang-Claude Jenny, Bergmann Manuela M, Boeing Heiner, Trichopoulos Dimitrios, Trichopoulou Antonia, Oikonomou Eleni, Berrino Franco, Palli Domenico, Tumino Rosario, Vineis Paolo, Panico Salvatore, Peeters Petra Hm, Bueno-de-Mesquita H Bas, Kiemeney Lambertus, Gram Inger Torhild, Braaten Tonje, Lund Eiliv, Gonzalez Carlos A, Berglund Göran, Allen Naomi, Roddam Andrew, Bingham Sheila, Riboli Elio
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
Int J Cancer. 2006 Nov 15;119(10):2412-6. doi: 10.1002/ijc.22169.
The purpose of the present study was to investigate the association between smoking and the development of bladder cancer. The study population consisted of 429,906 persons participating in the European Prospective Investigation into Cancer and Nutrition (EPIC), 633 of whom developed bladder cancer during the follow-up period. An increased risk of bladder cancer was found for both current- (incidence rate ratio 3.96, 95% confidence interval: 3.07-5.09) and ex- (2.25, 1.74-2.91) smokers, compared to never-smokers. A positive association with intensity (per 5 cigarettes) was found among current-smokers (1.18, 1.09-1.28). Associations (per 5 years) were observed for duration (1.14, 1.08-1.21), later age at start (0.75, 0.66-0.85) and longer time since quitting (0.92, 0.86-0.98). Exposure to environmental tobacco smoke (ETS) during childhood increased the risk of bladder cancer (1.38, 1.00-1.90), whereas for ETS exposure as adult no effect was detected. The present study confirms the strong association between smoking and bladder cancer. The indication of a higher risk of bladder cancer for those who start smoking at a young age and for those exposed to ETS during childhood adds to the body of evidence suggesting that children are more sensitive to carcinogens than adults.
本研究的目的是调查吸烟与膀胱癌发生之间的关联。研究人群包括429,906名参与欧洲癌症与营养前瞻性调查（EPIC）的人员，其中633人在随访期间患上了膀胱癌。与从不吸烟者相比，当前吸烟者（发病率比3.96，95%置信区间：3.07 - 5.09）和既往吸烟者（2.25，1.74 - 2.91）患膀胱癌的风险均增加。在当前吸烟者中发现与吸烟强度（每5支香烟）呈正相关（1.18，1.09 - 1.28）。观察到与吸烟持续时间（每5年）（1.14，1.08 - 1.21）、开始吸烟年龄较大（0.75，0.66 - 0.85）以及戒烟后时间较长（0.92，0.86 - 0.98）存在关联。儿童时期暴露于环境烟草烟雾（ETS）会增加患膀胱癌的风险（1.38，1.00 - 1.90），而成年后暴露于ETS则未检测到影响。本研究证实了吸烟与膀胱癌之间的紧密关联。对于那些年轻时开始吸烟的人和儿童时期暴露于ETS的人患膀胱癌风险较高的迹象，进一步补充了表明儿童比成年人对致癌物更敏感的证据。
