School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK.
Cancer Causes Control. 2011 Mar;22(3):487-94. doi: 10.1007/s10552-010-9723-2. Epub 2011 Jan 30.
The association between childhood environmental tobacco smoke (ETS) exposure and adult cancer risk is controversial; we examined this relationship in never smokers within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Over an average of 10 years, 8,372 cases of cancer were diagnosed in 112,430 never smokers in EPIC. Childhood ETS was self-reported by participants at baseline, along with other lifestyle factors. Hazard ratios (HR) for ETS exposure in childhood and their 95% confidence intervals (CI) were estimated by Cox proportional hazards models stratified by age, sex, and study center and adjusted for education, alcohol drinking, body mass index, physical activity, non-alcoholic energy intake, fruit and vegetable intake, and adulthood ETS exposure. Models were further adjusted for reproductive factors for female cancers, for meat intake for digestive system cancers, and for diabetes status for pancreatic cancer. No association was observed between childhood ETS exposure and overall cancer risks (HR = 0.97, 95% CI = 0.92-1.02), and for selected sites. The only exception was pancreatic cancer, as previously reported by Vrieling et al., among those who had been exposed daily in childhood (overall HR = 2.09, 95% CI = 1.14-3.84). In conclusion, childhood ETS exposure might not be a major risk factor for common cancers in adulthood.
儿童时期接触环境烟草烟雾(ETS)与成人癌症风险之间的关联存在争议;我们在欧洲癌症前瞻性调查和营养研究(EPIC)队列中从未吸烟者中研究了这种关系。在 EPIC 中,112430 名从未吸烟者中,平均 10 年内诊断出 8372 例癌症。儿童时期的 ETS 是由参与者在基线时自我报告的,同时还报告了其他生活方式因素。通过 Cox 比例风险模型,按年龄、性别和研究中心分层,并根据教育、饮酒、体重指数、身体活动、非酒精能量摄入、水果和蔬菜摄入以及成年期 ETS 暴露情况进行调整,估计 ETS 暴露在儿童时期的风险比(HR)及其 95%置信区间(CI)。对于女性癌症,还针对生殖因素进行了调整;对于消化系统癌症,还针对肉类摄入量进行了调整;对于胰腺癌,还针对糖尿病状况进行了调整。儿童时期 ETS 暴露与总体癌症风险(HR = 0.97,95%CI = 0.92-1.02)之间没有观察到关联,与选定的部位也没有关联。唯一的例外是胰腺癌,正如 Vrieling 等人之前报道的那样,在儿童时期每天接触 ETS 的人群中(总体 HR = 2.09,95%CI = 1.14-3.84)。总之,儿童时期接触 ETS 可能不是成人常见癌症的主要危险因素。