Wang X-R, Chiu Y-L, Qiu H, Au J S K, Yu I T-S
Department of Community and Family Medicine, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Ann Oncol. 2009 Apr;20(4):746-51. doi: 10.1093/annonc/mdn699. Epub 2009 Jan 15.
We conducted this case-control study to evaluate smoking effect on lung cancer conditional on the level of exposure to cooking emissions and to explore whether there is a joint effect of these two risk factors.
We selected 279 newly diagnosed primary lung cancer cases and 322 community controls from Hong Kong females, frequency matched by age group, and collected relevant data. We applied logistic regression to estimate lung cancer risk related to smoking and cooking fume exposure, expressed as total cooking dish-years, while adjusting for various potential confounding factors.
Current smoking was associated with four-fold increased risk, and ex-smoking with two-fold risk, which was not much influenced by cooking dish-years. No increased risk was observed in environmental tobacco smoking. Increasing intakes of yellow/orange vegetables and multivitamins were significant protective factors in all models. In the analysis of joint effect, the combination of smoking and cooking dish-years tended to have a greater risk than exposure to cooking fumes alone. There was a dose-response gradient with total dish-years in nonsmokers, but not in smokers. Smoking was more strongly associated with nonadenocarcinoma, whereas exposure to cooking fumes appeared to be related to both adenocarcinoma and nonadenocarcinoma.
We confirmed the important roles of smoking and cooking emissions in lung cancer risk among the women. These two major risk factors appeared to act independently.
我们开展了这项病例对照研究,以评估在接触烹饪油烟水平的条件下吸烟对肺癌的影响,并探讨这两种危险因素是否存在联合作用。
我们从香港女性中选取了279例新诊断的原发性肺癌病例和322例社区对照,按年龄组进行频数匹配,并收集相关数据。我们应用逻辑回归来估计与吸烟和烹饪油烟暴露相关的肺癌风险,以总烹饪盘年数表示,同时对各种潜在混杂因素进行校正。
当前吸烟者的风险增加四倍,既往吸烟者的风险增加两倍,且受烹饪盘年数的影响不大。被动吸烟未观察到风险增加。在所有模型中,增加黄色/橙色蔬菜和多种维生素的摄入量是显著的保护因素。在联合作用分析中,吸烟与烹饪盘年数的组合往往比单独接触烹饪油烟具有更大的风险。在不吸烟者中,总盘年数存在剂量反应梯度,但吸烟者中不存在。吸烟与非腺癌的关联更强,而接触烹饪油烟似乎与腺癌和非腺癌均有关。
我们证实了吸烟和烹饪油烟排放对女性肺癌风险的重要作用。这两个主要危险因素似乎独立起作用。