日本人群中吸烟与头颈癌风险：一项系统评价与荟萃分析
Cigarette smoking and the risk of head and neck cancer in the Japanese population: a systematic review and meta-analysis.
作者信息
Koyanagi Yuriko N, Matsuo Keitaro, Ito Hidemi, Wakai Kenji, Nagata Chisato, Nakayama Tomio, Sadakane Atsuko, Tanaka Keitaro, Tamakoshi Akiko, Sugawara Yumi, Mizoue Tetsuya, Sawada Norie, Inoue Manami, Tsugane Shoichiro, Sasazuki Shizuka, Sasazuki Shizuka, Tsugane Shoichiro, Inoue Manami, Iwasaki Motoki, Otani Tetsuya, Sawada Norie, Shimazu Taichi, Yamaji Taiki, Tsuji Ichiro, Tsubono Yoshitaka, Nishino Yoshikazu, Tamakoshi Akiko, Matsuo Keitaro, Ito Hidemi, Wakai Kenji, Nagata Chisato, Mizoue Tetsuya, Tanaka Keitaro, Nakayama Tomio, Sadakane Atsuko
机构信息
Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya.
Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya
出版信息
Jpn J Clin Oncol. 2016 Jun;46(6):580-95. doi: 10.1093/jjco/hyw027. Epub 2016 Apr 24.
OBJECTIVE
Although cigarette smoking is a well-established risk factor for head and neck cancer, the impact of smoking on head and neck cancer might vary among geographic areas. To date, however, no systematic review of cigarette smoking and head and neck cancer in the Japanese population has yet appeared.
METHODS
We conducted a systematic review of previous epidemiological studies for cigarette smoking and head and neck cancer among Japanese. Evaluation of associations was based on the strength of evidence ('convincing', 'probable', 'possible' or 'insufficient') and the magnitude of association ('strong', 'moderate', 'weak' or 'no association'), together with biological plausibility as previously evaluated by the International Agency for Research on Cancer. A meta-analysis was conducted to obtain summary estimates for the overall magnitude of association.
RESULTS
We identified five cohort studies and 12 case-control studies. Four of five cohort studies and 11 of 12 case-control studies showed a strong positive association between cigarette smoking and head and neck cancer. Nine of 12 studies indicated a dose-response relationship between cigarette smoking and the risk of head and neck cancer. Meta-analysis of 12 studies indicated that the summary relative risk for ever smokers relative to never smokers was 2.43 (95% confidence interval: 2.09-2.83). Summary relative risks for current and former smokers relative to never smokers were 2.68 (2.08-3.44) and 1.49 (1.05-2.11), respectively.
CONCLUSIONS
Cigarette smoking is a convincing risk factor for head and neck cancer in the Japanese population.
目的
尽管吸烟是头颈癌公认的风险因素，但吸烟对头颈癌的影响可能因地理区域而异。然而，迄今为止，尚未出现对日本人群中吸烟与头颈癌关系的系统综述。
方法
我们对以往关于日本人群吸烟与头颈癌的流行病学研究进行了系统综述。基于证据强度（“令人信服”“很可能”“可能”或“证据不足”）和关联程度（“强”“中度”“弱”或“无关联”）对关联进行评估，并结合国际癌症研究机构先前评估的生物学合理性。进行荟萃分析以获得关联总体程度的汇总估计值。
结果
我们确定了5项队列研究和12项病例对照研究。5项队列研究中的4项以及12项病例对照研究中的11项显示吸烟与头颈癌之间存在强正相关。12项研究中的9项表明吸烟与头颈癌风险之间存在剂量反应关系。对12项研究的荟萃分析表明，曾经吸烟者相对于从不吸烟者的汇总相对风险为2.43（95%置信区间：2.09 - 2.83）。当前吸烟者和既往吸烟者相对于从不吸烟者的汇总相对风险分别为2.68（2.08 - 3.44）和1.49（1.05 - 2.11）。
结论
在日本人群中，吸烟是头颈癌令人信服的风险因素。
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