Lugo Alessandra, Bosetti Cristina, Peveri Giulia, Rota Matteo, Bagnardi Vincenzo, Gallus Silvano
Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
BMJ Open. 2017 Nov 1;7(10):e018930. doi: 10.1136/bmjopen-2017-018930.
Only a limited number of meta-analyses providing risk curve functions of dose-response relationships between various smoking-related variables and cancer-specific risk are available.
To identify all relevant original publications on the issue, we will conduct a series of comprehensive systematic reviews based on three subsequent literature searches: (1) an umbrella review, to identify meta-analyses, pooled analyses and systematic reviews published before 28 April 2017 on the association between cigarette smoking and the risk of 28 (namely all) malignant neoplasms; (2) for each cancer site, an updated review of original publications on the association between cigarette smoking and cancer risk, starting from the last available comprehensive review identified through the umbrella review; and (3) a review of all original articles on the association between cigarette smoking and site-specific cancer risk included in the publications identified through the umbrella review and the updated reviews. The primary outcomes of interest will be (1) the excess incidence/mortality of various cancers for smokers compared with never smokers; and (2) the dose-response curves describing the association between smoking intensity, duration and time since stopping and incidence/mortality for various cancers. For each cancer site, we will perform a meta-analysis by pooling study-specific estimates for smoking status. We will also estimate the dose-response curves for other smoking-related variables through random-effects meta-regression models based on a non-linear dose-response relationship framework.
Ethics approval is not required for this study. Main results will be published in peer-reviewed journals and will also be included in a publicly available website. We will provide therefore the most complete and updated estimates on the association between various measures of cigarette smoking and site-specific cancer risk. This will allow us to obtain precise estimates on the cancer burden attributable to cigarette smoking.
This protocol was registered in the International Prospective Register of Systematic Reviews (CRD42017063991).
目前仅有数量有限的荟萃分析提供了各种吸烟相关变量与癌症特异性风险之间剂量反应关系的风险曲线函数。
为了识别该问题的所有相关原始出版物，我们将基于三次连续的文献检索进行一系列全面的系统评价：（1）一项概述性综述，以识别2017年4月28日前发表的关于吸烟与28种（即所有）恶性肿瘤风险关联的荟萃分析、汇总分析和系统评价；（2）对于每个癌症部位，从通过概述性综述确定的最后一篇可用的全面综述开始，对吸烟与癌症风险关联的原始出版物进行更新综述；（3）对通过概述性综述和更新综述确定的出版物中包含的吸烟与特定部位癌症风险关联的所有原始文章进行综述。感兴趣的主要结局将是：（1）吸烟者与从不吸烟者相比各种癌症的超额发病率/死亡率；（2）描述吸烟强度、持续时间和戒烟时间与各种癌症发病率/死亡率之间关联的剂量反应曲线。对于每个癌症部位，我们将通过汇总研究特定的吸烟状态估计值进行荟萃分析。我们还将通过基于非线性剂量反应关系框架的随机效应荟萃回归模型估计其他吸烟相关变量的剂量反应曲线。
本研究无需伦理批准。主要结果将发表在同行评审期刊上，也将纳入一个公开可用的网站。因此，我们将提供关于各种吸烟测量指标与特定部位癌症风险之间关联的最完整和最新估计。这将使我们能够获得归因于吸烟的癌症负担的精确估计。
本方案已在国际前瞻性系统评价注册库（CRD42017063991）注册。
