Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, England; Division of Epidemiology and Public Health, University of Nottingham, Nottingham, England.
Division of Epidemiology and Public Health, University of Nottingham, Nottingham, England.
Chest. 2013 Jan;143(1):123-129. doi: 10.1378/chest.12-1068.
Studies have shown that for the same quantity of cigarettes smoked, women are more likely to develop heart disease than men, but studies in lung cancer have produced conflicting results. We studied the association between smoking quantity and lung cancer in men and women.
Using data from The Health Improvement Network (a UK medical research database), we generated a data set comprising 12,121 incident cases of lung cancer and 48,216 age-, sex-, and general practice-matched control subjects. We used conditional logistic regression to calculate ORs for lung cancer according to highest-ever-quantity smoked in men and women separately.
The odds of lung cancer in women who had ever smoked heavily compared with those who had never smoked were increased 19-fold (OR, 19.10; 95% CI, 16.98-21.49), which was more than for men smoking the same quantity (OR, 12.81; 95% CI, 11.52-14.24). There was strong evidence of a difference in effect of quantity smoked on lung cancer between men and women (interaction P < .0001), which remained after adjusting for height (a proxy marker for lung volume).
Moderate and heavy smoking carry a higher risk of lung cancer in women than in men, and this difference does not seem to be explained by lung volume. The findings suggest that extrapolating risk estimates for lung cancer in men to women will underestimate the adverse impact of smoking in women.
研究表明，对于相同数量的吸烟量，女性比男性更容易患心脏病，但肺癌研究结果却相互矛盾。我们研究了吸烟量与男性和女性肺癌之间的关系。
利用英国医疗研究数据库“健康改善网络”的数据，我们生成了一个包含 12121 例肺癌新发病例和 48216 例年龄、性别和全科医生匹配对照的数据集。我们使用条件逻辑回归分别计算了男性和女性中最高吸烟量与肺癌之间的比值比（OR）。
与从不吸烟的女性相比，重度吸烟女性患肺癌的几率增加了 19 倍（OR，19.10；95%CI，16.98-21.49），这一比例高于相同吸烟量的男性（OR，12.81；95%CI，11.52-14.24）。男性和女性吸烟量对肺癌影响的差异有很强的证据（交互 P <.0001），即使在调整了身高（肺容积的替代标志物）后，这种差异仍然存在。
中度和重度吸烟使女性患肺癌的风险高于男性，而且这种差异似乎不能用肺容积来解释。这些发现表明，将男性肺癌风险估计值外推到女性身上，将低估吸烟对女性的不利影响。
