Hama Hitomi, Tabuchi Takahiro, Ito Yuri, Fukushima Wakaba, Matsunaga Ichiro, Miyashiro Isao, Nakayama Tomio
Osaka Medical Center for Cancer and Cardiovascular Diseases Department of Cancer Control and Statistics.
Nihon Koshu Eisei Zasshi. 2016;63(3):126-34. doi: 10.11236/jph.63.3_126.
Early detection of cancer incidence and tobacco control are prioritized in the second-term of the Basic Plan for Promotion of Cancer Measures. However, the cancer screening rate is low and smoking prevalence high in Japan. Smokers may not participate in cancer screening, although they are a high-risk population for cancer mortality. This study examined whether smoking status, including number of cigarettes smoked per day and the Brinkman index (BI), was associated with participation in screening for lung, gastric, and colorectal cancers.
In 2011, we conducted a cross-sectional study in Osaka city: 2,016 subjects aged 40 to 64 (men, N=966; women, N=1,050) were analyzed (response rate=52.4%). We used multivariable logistic regression with stratification by sex to calculate odds ratios (ORs) for participation in screening for lung, gastric, and colorectal cancers according to smoking status, such as number of cigarettes smoked per day and the BI.
Compared with non-current smokers, current smokers were less likely to participate in all cancer screenings. Men who currently smoke had significantly lower odds for gastric and colorectal cancer screening participation than non-current smokers (gastric : OR=0.71, P=0.036 ; colorectal : OR=0.67, P=0.012). Furthermore, compared with non-current smokers, men who smoked more than 20 cigarettes per day had significantly lower odds for all cancer screenings (lung: OR=0.61, P=0.009; gastric: OR=0.61, P=0.009; colorectal: OR=0.59, P=0.004). Similar results were observed in smokers with a BI≧600 (lung: OR=0.55, P=0.006; gastric: OR=0.62, P=0.028; colorectal: OR=0.56, P=0.006). Among the women, significant associations between number of cigarettes smoked per day, BI, and colorectal cancer screening participation were observed (more than 20 cigarettes per day: OR=0.39, P=0.004; BI≧400: OR=0.51, P=0.020).
Current smokers were less likely to undergo cancer screening compared with non-current smokers. These associations were stronger in men with greater numbers of cigarettes smoked per day and a higher BI score. Because smokers do not receive cancer screening, they may be at higher risk for cancer mortality. Counseling at the chance of cancer screening should be considered as a good opportunity to provide useful information on smoking cessation, as well as to promote cancer screening participation.
在《癌症防治基本计划》第二期，癌症发病率的早期检测和烟草控制被列为优先事项。然而，日本的癌症筛查率较低，吸烟率较高。吸烟者可能不参加癌症筛查，尽管他们是癌症死亡的高危人群。本研究调查了吸烟状况，包括每日吸烟量和布林克曼指数（BI），是否与肺癌、胃癌和结直肠癌的筛查参与情况有关。
2011年，我们在大阪市进行了一项横断面研究：对2016名年龄在40至64岁之间的受试者（男性966名，女性1050名）进行了分析（应答率 = 52.4%）。我们采用多变量逻辑回归，并按性别分层，以计算根据吸烟状况（如每日吸烟量和BI）参与肺癌、胃癌和结直肠癌筛查的比值比（OR）。
与非当前吸烟者相比，当前吸烟者参加所有癌症筛查的可能性较小。当前吸烟的男性参加胃癌和结直肠癌筛查的几率显著低于非当前吸烟者（胃癌：OR = 0.71，P = 0.036；结直肠癌：OR = 0.67，P = 0.012）。此外，与非当前吸烟者相比，每日吸烟超过20支的男性参加所有癌症筛查的几率显著较低（肺癌：OR = 0.61，P = 0.009；胃癌：OR = 0.61，P = 0.
