Park Song-Yi, Palmer Julie R, Rosenberg Lynn, Haiman Christopher A, Bandera Elisa V, Bethea Traci N, Troester Melissa A, Viscidi Emma, Kolonel Laurence N, Olshan Andrew F, Ambrosone Christine B
Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA,
Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA 02215, USA.
Carcinogenesis. 2016 Jun;37(6):607-15. doi: 10.1093/carcin/bgw040. Epub 2016 Apr 7.
Recent population studies suggest a role of smoking in the etiology of breast cancer, but few have been conducted among African American women. In a collaborative project of four large studies, we examined associations between smoking measures and breast cancer risk by menopause and hormone receptor status [estrogen receptor-positive (ER+), ER-negative (ER-) and triple-negative (ER-, PR-, HER2-)]. The study included 5791 African American women with breast cancer and 17376 African American controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in multivariable logistic regression analysis with adjustment for study and risk factors. Results differed by menopausal status. Among postmenopausal women, positive associations were observed for long duration and greater pack-years of smoking: relative to never smoking, fully adjusted ORs were 1.14 (95% CI: 1.03-1.26) for duration ≥20 years and 1.16 (95% CI: 1.01-1.33) for ≥20 pack-years. By contrast, inverse associations were observed among premenopausal women, with ORs of 0.80 (95% CI: 0.68-95) for current smoking and 0.81 (95% CI: 0.69-0.96) for former smoking, without trends by duration. Associations among postmenopausal women were somewhat stronger for ER+ breast cancer. The findings suggest that the relation of cigarette smoking to breast cancer risk in African American women may vary by menopausal status and breast cancer subtype.
近期的人群研究表明吸烟在乳腺癌病因中起一定作用，但针对非裔美国女性的此类研究较少。在四项大型研究的合作项目中，我们根据绝经状态和激素受体状态[雌激素受体阳性（ER+）、雌激素受体阴性（ER-）和三阴性（ER-、PR-、HER2-）]研究了吸烟指标与乳腺癌风险之间的关联。该研究纳入了5791名患有乳腺癌的非裔美国女性和17376名非裔美国对照者。在多变量逻辑回归分析中计算比值比（OR）和95%置信区间（CI），并对研究和风险因素进行了调整。结果因绝经状态而异。在绝经后女性中，观察到吸烟持续时间长和吸烟包年数多与乳腺癌呈正相关：与从不吸烟相比，对于持续时间≥20年的情况，完全调整后的OR为1.14（95%CI：1.03 - 1.26）；对于≥20包年的情况，OR为1.16（95%CI：1.01 - 1.33）。相比之下，在绝经前女性中观察到负相关，当前吸烟者的OR为0.80（95%CI：0.68 - 0.95），既往吸烟者的OR为0.81（95%CI：0.69 - 0.96），且未随持续时间呈现出趋势。绝经后女性中，吸烟与ER+乳腺癌之间的关联更强。这些发现表明，非裔美国女性中吸烟与乳腺癌风险的关系可能因绝经状态和乳腺癌亚型而异。
