Licciardone J C, Brownson R C, Chang J C, Wilkins J R
Department of Public Health and Preventive Medicine, Texas College of Osteopathic Medicine, Fort Worth 76107.
Am J Prev Med. 1990 Sep-Oct;6(5):274-81.
We conducted a meta-analytic study to measure the risk of uterine cervical cancer in former and current smokers. A literature search from 1966 to 1988 identified 139 MEDLINE citations. Of these, five studies reported appropriate and complete data for meta-analysis. A recent study conducted by the authors was also included. The graphical and variance-based methods of meta-analysis consistently demonstrated a significantly excessive risk of cervical cancer in current smokers, but not in former smokers. The powers of the analyses involving former smokers were between 0.72 and 0.99, depending on the degree of confounding attributed to unmeasured variables. Thus, it was unlikely that sample size accounted for the null association observed in former smokers. These findings have important medical implications for women in light of the prevalence of cigarette smoking. During regular gynecologic screening examinations, health care professionals may have considerable impact by counseling women about the risk of cervical cancer in smokers. Antismoking messages should be strongly directed toward women in the lower educational and socioeconomic levels to have the greatest impact on the incidence of cervical cancer.
我们进行了一项荟萃分析研究，以衡量既往吸烟者和当前吸烟者患子宫颈癌的风险。对1966年至1988年的文献检索共识别出139条MEDLINE引用文献。其中，五项研究报告了适用于荟萃分析的完整数据。作者近期开展的一项研究也被纳入。基于图形和方差的荟萃分析方法均一致表明，当前吸烟者患子宫颈癌的风险显著过高，但既往吸烟者并非如此。涉及既往吸烟者的分析效能在0.72至0.99之间，具体取决于未测量变量导致的混杂程度。因此，样本量不太可能是既往吸烟者中观察到的无关联的原因。鉴于吸烟的普遍性，这些发现对女性具有重要的医学意义。在常规妇科筛查检查期间，医护人员通过向女性咨询吸烟者患子宫颈癌的风险可能会产生相当大的影响。应大力向教育程度和社会经济水平较低的女性传达反吸烟信息，以便对子宫颈癌的发病率产生最大影响。
