Cigarette smoking and cancer mortality risk in Japanese men and women--results from reanalysis of the six-prefecture cohort study data.

In 1965 a cohort of 265,000 residents of 29 public health districts in six prefectures throughout Japan was established and followed between 1966 and 1981. By using survival analysis based on Poisson regression models adjusted for age, prefecture of residence, and occupation, a statistically significant dose-response relationship between cigarette smoking and mortality rate was found for cancers of the liver, pancreas, and lung in both sexes; cancers of the oral cavity, esophagus, stomach, larynx, and bladder in men; and cancer of the uterus in women. The magnitudes of relative risks were only slightly affected by adjustment for prefecture of residence or occupation. Analysis using linear relative risk models revealed that the inclusion of a quadratic term for the amount of daily cigarette consumption in addition to the linear term improved the fit of the model significantly for cancers of the esophagus and stomach in men and cancer of the stomach in women. The sex ratio of gastric cancer mortality was higher among smokers than among nonsmokers. When the follow-up period was divided into four 4-year intervals, it was noted that the relative mortality risk associated with lung cancer among males increased significantly during these time periods.