Chang Ellen T, Liu Zhiwei, Hildesheim Allan, Liu Qing, Cai Yonglin, Zhang Zhe, Chen Guomin, Xie Shang-Hang, Cao Su-Mei, Shao Jian-Yong, Jia Wei-Hua, Zheng Yuming, Liao Jian, Chen Yufeng, Lin Longde, Ernberg Ingemar, Vaughan Thomas L, Adami Hans-Olov, Huang Guangwu, Zeng Yi, Zeng Yi-Xin, Ye Weimin
Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.
Center for Health Sciences, Exponent, Inc., Menlo Park, California.
Am J Epidemiol. 2017 Jun 15;185(12):1272-1280. doi: 10.1093/aje/kwx018.
The magnitude and patterns of associations between smoking and risk of nasopharyngeal carcinoma (NPC) in high-incidence regions remain uncertain. Associations with active and passive tobacco smoking were estimated using multivariate logistic regression in a population-based case-control study of 2,530 NPC cases and 2,595 controls in Guangdong and Guangxi, southern China, in 2010-2014. Among men, risk of NPC was significantly higher in current smokers compared with never smokers (odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.14, 1.53) but not in former smokers (OR = 0.92, 95% CI: 0.73, 1.17). Risk increased with smoking intensity (per 10 cigarettes/day, OR = 1.09, 95% CI: 1.03, 1.16), smoking duration (per 10 years, OR = 1.11, 95% CI: 1.06, 1.16), and cumulative smoking (per 10 pack-years, OR = 1.08, 95% CI: 1.04, 1.12). Risk decreased with later age at smoking initiation (per year, OR = 0.97, 95% CI: 0.96, 0.98) but not greater time since smoking cessation. Exposures to passive smoking during childhood (OR = 1.24, 95% CI: 1.03, 1.48) and from a spouse during adulthood (OR = 1.30, 95% CI: 1.03, 1.63) were independently associated with increased NPC risk in never-smoking men and women, but exposure-response trends were not observed. In conclusion, active and passive tobacco smoking are associated with modestly increased risk of NPC in southern China; risk is highest among long-term smokers.
在鼻咽癌高发地区，吸烟与鼻咽癌风险之间关联的程度和模式仍不明确。在2010 - 2014年对中国南方广东和广西地区2530例鼻咽癌病例和2595例对照进行的一项基于人群的病例对照研究中，使用多因素逻辑回归分析了主动吸烟和被动吸烟的关联。在男性中，当前吸烟者患鼻咽癌的风险显著高于从不吸烟者（比值比（OR）= 1.32，95%置信区间（CI）：1.14，1.53），但既往吸烟者无显著差异（OR = 0.92，95% CI：0.73，1.17）。风险随吸烟强度（每增加10支/天，OR = 1.09，95% CI：1.03，1.16）、吸烟持续时间（每增加10年，OR = 1.11，95% CI：1.06，1.16）和累积吸烟量（每增加10包年，OR = 1.08，95% CI：1.04，1.12）增加。风险随开始吸烟年龄增大而降低（每年，OR = 0.97，95% CI：0.96，0.98），但与戒烟后时间长短无关。儿童期被动吸烟暴露（OR = 1.24，95% CI：1.03，1.48）和成年期配偶被动吸烟暴露（OR = 1.30，95% CI：1.03，1.63）与从不吸烟的男性和女性患鼻咽癌风险增加独立相关，但未观察到暴露 - 反应趋势。总之，主动吸烟和被动吸烟与中国南方地区鼻咽癌风险适度增加相关；长期吸烟者风险最高。
