Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Cancer Prev Res (Phila). 2017 Dec;10(12):704-709. doi: 10.1158/1940-6207.CAPR-17-0084. Epub 2017 Sep 28.
Use of non-cigarette tobacco products such as cigars and pipe has been increasing, even though these products entail exposure to similar carcinogens to those in cigarettes. More research is needed to explore the risk of these products to guide cancer prevention efforts. To measure the association between cigars and/or pipe smoking, and cancer incidence in men, we performed meta-analyses of data from five prospective cohorts. Cox regression was used to evaluate the association between different aspects of cigars and pipe smoking and risk of each smoking-related cancer (head and neck, esophagus, lung, stomach, liver, pancreas, kidney, and bladder) for each study. Adjusted HRs were combined using random-effects models. Cigars and/or pipe smokers were at increased risk for head and neck [HR, 1.51; 95% confidence interval (CI), 1.22-1.87], lung (HR, 2.04; 95% CI, 1.68-2.47), and liver cancers (HR, 1.56; 95% CI, 1.08-2.26). Ever-smokers of cigars and/or pipe had an increased risk of developing a smoking-related cancer when compared with never smokers of any tobacco product (overall HR, 1.07; 95% CI, 1.03-1.12). The risk for smoking-related cancers was also increased in mixed smokers who smoked cigars or pipe as well as cigarettes, even when they were smoking predominantly pipe or cigars. This pooled analysis highlights the increased risk for smoking-related cancers, particularly for lung and head and neck cancers in exclusive and predominant smokers (former and current) of cigars and pipe. Tobacco prevention efforts should include these products in addition to cigarettes. .
使用雪茄和烟斗等非香烟烟草制品的情况有所增加，尽管这些产品会接触到与香烟类似的致癌物质。需要进一步研究以探索这些产品的风险，为癌症预防工作提供指导。为了衡量雪茄和/或烟斗吸烟与男性癌症发病率之间的关联，我们对来自五个前瞻性队列的数据进行了荟萃分析。Cox 回归用于评估不同方面的雪茄和烟斗吸烟与每种吸烟相关癌症（头颈部、食管、肺、胃、肝、胰腺、肾和膀胱）风险之间的关联，每个研究都进行了评估。使用随机效应模型合并调整后的 HR。雪茄和/或烟斗吸烟者头颈部癌症的风险增加（HR，1.51；95%置信区间[CI]，1.22-1.87）、肺癌（HR，2.04；95%CI，1.68-2.47）和肝癌（HR，1.56；95%CI，1.08-2.26）。与从未使用过任何烟草制品的人相比，曾经使用过雪茄和/或烟斗的人患吸烟相关癌症的风险增加（总体 HR，1.07；95%CI，1.03-1.12）。与从不吸烟的人相比，混合吸烟者（同时吸烟雪茄和/或烟斗以及香烟）患吸烟相关癌症的风险也增加，即使他们主要吸烟斗或雪茄。这项汇总分析强调了吸烟相关癌症的风险增加，特别是对于独家和主要吸烟者（前吸烟者和现吸烟者）的肺癌和头颈部癌症。烟草预防工作除了香烟之外，还应该包括这些产品。
