Meta-Analysis Research Group, Columbia, SC 29209, USA.
Am J Public Health. 2010 Apr;100(4):693-701. doi: 10.2105/AJPH.2008.150508. Epub 2009 Jul 16.
We evaluated the relationship between smoking and adenocarcinoma of the prostate.
We pooled data from 24 cohort studies enrolling 21 579 prostate cancer case participants for a general variance-based meta-analysis. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated separately for mortality and incidence studies. We tested the robustness of effect measures and evaluated statistical heterogeneity with sensitivity analyses.
In the pooled data, current smokers had no increased risk of incident prostate cancer (RR = 1.04; 95% CI = 0.87, 1.24), but in data stratified by amount smoked they had statistically significant elevated risk (cigarettes per day or years: RR = 1.22; 95% CI = 1.01, 1.46; pack years of smoking: RR = 1.11; 95% CI = 1.01, 1.22). Former smokers had an increased risk (RR = 1.09; 95% CI = 1.02, 1.16). Current smokers had an increased risk of fatal prostate cancer (RR = 1.14; 95% CI = 1.06, 1.19). The heaviest smokers had a 24% to 30% greater risk of death from prostate cancer than did nonsmokers.
Observational cohort studies show an association of smoking with prostate cancer incidence and mortality. Ill-defined exposure categories in many cohort studies suggest that pooled data underestimate risk.
评估吸烟与前列腺腺癌之间的关系。
我们对纳入了 21579 例前列腺癌病例参与者的 24 项队列研究的数据进行了汇总，采用基于方差的荟萃分析进行了总体分析。分别针对死亡率和发病率研究计算了汇总相对风险（RR）和 95%置信区间（CI）。我们用敏感性分析来检验效应衡量值的稳健性并评估统计异质性。
在汇总数据中，当前吸烟者发生前列腺癌的风险没有增加（RR=1.04；95%CI=0.87，1.24），但在按吸烟量分层的数据中，他们的风险显著升高（每天吸烟量或吸烟年数：RR=1.22；95%CI=1.01，1.46；吸烟包年数：RR=1.11；95%CI=1.01，1.22）。曾经吸烟者的风险增加（RR=1.09；95%CI=1.02，1.16）。当前吸烟者死于前列腺癌的风险增加（RR=1.14；95%CI=1.06，1.19）。重度吸烟者死于前列腺癌的风险比不吸烟者高 24%至 30%。
观察性队列研究表明，吸烟与前列腺癌的发病率和死亡率有关。许多队列研究中暴露分类不明确，表明汇总数据低估了风险。
