Taylor Richard, Najafi Farid, Dobson Annette
School of Population Health, University of Queensland, Australia.
Int J Epidemiol. 2007 Oct;36(5):1048-59. doi: 10.1093/ije/dym158. Epub 2007 Aug 9.
To calculate a pooled estimate of relative risk (RR) of lung cancer associated with exposure to passive smoking in never smoking women exposed to smoking spouses. This study is an updated meta-analysis that also assesses the differences between estimated risks according to continent and study type using meta-regression.
From a total of 101 primary studies, 55 studies are included in this meta-analysis, of which, 7 are cohort studies, 25 population-based case-control and 23 non-population-based case-control studies. Twenty previously published meta-analyses are also reviewed. Fixed and random effect models and meta-regression are used to obtain pooled estimates of RR and P-value functions are used to demonstrate consistency of results.
The pooled RR for never-smoking women exposed to passive smoking from spouses is 1.27 (95% CI 1.17-1.37). The RR for North America is 1.15 (95% CI 1.03-1.28), Asia, 1.31 (95% CI 1.16-1.48) and Europe, 1.31 (1.24-1.52). Sequential cumulative meta-analysis shows no trend. There is no strong evidence of publication bias.
The abundance of evidence, consistency of finding across continent and study type, dose-response relationship and biological plausibility, overwhelmingly support the existence of a causal relationship between passive smoking and lung cancer.
计算在配偶吸烟的从不吸烟女性中，与被动吸烟相关的肺癌相对风险（RR）的合并估计值。本研究是一项更新的荟萃分析，还使用荟萃回归评估了根据大洲和研究类型估计的风险之间的差异。
在总共101项原始研究中，55项研究纳入了本荟萃分析，其中7项为队列研究，25项基于人群的病例对照研究和23项非基于人群的病例对照研究。还对之前发表的20项荟萃分析进行了综述。使用固定效应模型、随机效应模型和荟萃回归来获得RR的合并估计值，并使用P值函数来证明结果一致性。
配偶吸烟的从不吸烟女性的合并RR为1.27（95%CI 1.17 - 1.37）。北美洲的RR为1.15（95%CI 1.03 - 1.28），亚洲为1.31（95%CI 1.16 - 1.48），欧洲为1.3(1.24 - 1.52)。序贯累积荟萃分析未显示出趋势。没有强有力的证据表明存在发表偏倚。
大量证据、各大洲和研究类型间结果的一致性、剂量反应关系及生物学合理性，压倒性地支持被动吸烟与肺癌之间存在因果关系。
