Papadopoulos A, Guida F, Leffondré K, Cénée S, Cyr D, Schmaus A, Radoï L, Paget-Bailly S, Carton M, Menvielle G, Woronoff A-S, Tretarre B, Luce D, Stücker I
1] Environmental Epidemiology of Cancer, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, 94807 Villejuif, France [2] Université Paris Sud 11, UMRS 1018, 94807 Villejuif, France.
Université Bordeaux Segalen, Inserm U897, 33076 Bordeaux, France.
Br J Cancer. 2014 Mar 4;110(5):1385-91. doi: 10.1038/bjc.2013.821. Epub 2014 Jan 14.
Whether women are more or equally susceptible to the carcinogenic effects of cigarette smoke on the lungs compared with men is a matter of controversy. Using a large French population-based case-control study, we compared the lung cancer risk associated with cigarette smoking by gender.
The study included 2276 male and 650 female cases and 2780 male and 775 female controls. Lifetime smoking exposure was represented by the comprehensive smoking index (CSI), which combines the duration, intensity and time since cessation of smoking habits. The analysis was conducted among the ever smokers. All of the models were adjusted for age, department (a regional administrative unit), education and occupational exposures.
Overall, we found that the lung cancer risk was similar among men and women. However, we found that women had a two-fold greater risk associated with a one-unit increase in CSI than men of developing either small cell carcinoma (OR=15.9, 95% confidence interval (95% CI) 7.6, 33.3 and 6.6, 95% CI 5.1, 8.5, respectively; P<0.05) or squamous cell carcinoma (OR=13.1, 95% CI 6.3, 27.3 and 6.1, 95% CI 5.0, 7.3, respectively; P<0.05). The association was similar between men and women for adenocarcinoma.
Our findings suggest that heavy smoking might confer to women a higher risk of lung cancer as compared with men.
与男性相比，女性对香烟烟雾对肺部致癌作用的易感性是更高还是相同，这是一个存在争议的问题。我们利用一项基于法国大量人群的病例对照研究，比较了按性别划分的与吸烟相关的肺癌风险。
该研究纳入了2276例男性病例和650例女性病例，以及2780例男性对照和775例女性对照。终生吸烟暴露情况用综合吸烟指数（CSI）表示，该指数综合了吸烟持续时间、强度以及戒烟时间。分析在曾经吸烟者中进行。所有模型均针对年龄、部门（一个地区行政单位）、教育程度和职业暴露进行了调整。
总体而言，我们发现男性和女性的肺癌风险相似。然而，我们发现，随着CSI每增加一个单位，女性患小细胞癌（比值比[OR]=15.9，95%置信区间[95%CI]为7.6，33.3；男性为6.6，95%CI为5.1，8.5；P<0.05）或鳞状细胞癌（OR=13.1，95%CI为6.3，27.3；男性为6.1，95%CI为5.0，7.3；P<0.05）的风险比男性高出两倍。腺癌在男性和女性中的关联相似。
我们的研究结果表明，与男性相比，重度吸烟可能使女性患肺癌的风险更高。
