Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Dr., Suite 1400, Chicago, IL 60611, USA.
Cancer Causes Control. 2012 Oct;23(10):1729-37. doi: 10.1007/s10552-012-9959-0. Epub 2012 Jul 24.
Understanding how sex and tobacco exposure may modify lifetime risks for cancer mortality is important for effective communication of risk in targeted public health messages.
To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States.
A pooled cohort design using ten well-defined epidemiologic cohorts including middle-aged and older individuals was used to estimate the lifetime risk for cancer death at selected index ages, with death from non-cancer causes as the competing risk, by sex and smoking status.
There were a total of 11,317 cancer-related deaths. At age 45 years, the lifetime risk of cancer death for male smokers is 27.7 % (95 % CI 24.0-31.4 %) compared to 15.8 % (95 % CI 12.7-18.9 %) for male non-smokers. At age 45 years, the lifetime risk of cancer death for female smokers is 21.7 % (95 % CI 18.8-24.6 %) compared to 13.2 % (95 % CI 11.0-15.4 %) for female non-smokers. Remaining lifetime risk for cancer death declined with age, and men have a greater risk for cancer death compared to women. Adjustment for competing risk of death, particularly representing cardiovascular mortality, yielded a greater change in lifetime risk estimates for men and smokers compared to women and non-smokers.
At the population level, the lifetime risk for cancer death remains significantly higher for smokers compared to non-smokers, regardless of sex. These estimates may provide clinicians with useful information for counseling individual patients and highlight the need for continued public health efforts related to smoking cessation.
了解性别和烟草暴露如何可能改变癌症死亡率的终生风险，对于在有针对性的公共卫生信息中有效传达风险非常重要。
确定与美国性别和吸烟状况相关的癌症死亡终生风险估计值。
使用十个明确界定的流行病学队列的汇总队列设计，包括中年和老年人，用于估计特定索引年龄的癌症死亡终生风险，以非癌症原因死亡为竞争风险，按性别和吸烟状况进行分层。
共有 11317 例癌症相关死亡。在 45 岁时，男性吸烟者的癌症死亡终生风险为 27.7%（95%CI 24.0-31.4%），而男性不吸烟者的终生风险为 15.8%（95%CI 12.7-18.9%）。在 45 岁时，女性吸烟者的癌症死亡终生风险为 21.7%（95%CI 18.8-24.6%），而女性不吸烟者的终生风险为 13.2%（95%CI 11.0-15.4%）。癌症死亡的剩余终生风险随年龄下降，男性死于癌症的风险大于女性。调整死亡的竞争风险，特别是心血管死亡率，与女性和非吸烟者相比，男性和吸烟者的终生风险估计值发生了更大的变化。
在人群水平上，与不吸烟者相比，无论性别如何，吸烟者的癌症死亡终生风险仍然显著更高。这些估计值可能为临床医生为个别患者提供咨询提供有用的信息，并强调需要继续开展与戒烟相关的公共卫生工作。
