Department of Complex Genetics, Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, PO Box 616, 6200MD Maastricht, The Netherlands.
Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Int J Environ Res Public Health. 2018 Mar 22;15(4):569. doi: 10.3390/ijerph15040569.
: Active smoking is a major risk factor for urothelial bladder cancer (UBC). However, the evidence that exposure to environmental tobacco smoke (ETS) either in childhood or adult life is also associated with UBC risk is ambiguous. With this meta-analysis, we aim to summarise how exposure to ETS is associated with UBC risk. : In total, 11 studies (3 cohort studies, 8 case-control studies) were included in this meta-analysis and summary odds ratios (SORs) for UBC risk were calculated for never smokers who were exposed to ETS during childhood at home, during adulthood at home, or during adulthood in a work environment compared to never smokers who were never exposed to ETS. Sensitivity analyses were conducted to test the robustness of findings. : Never smokers exposed to ETS during childhood (SOR = 1.04, 95% confidence interval (CI) = 0.82-1.26), during adulthood at work (SOR = 0.98, 95% CI = 0.78-1.18) or at home (SOR = 0.99, 95% CI = 0.83-1.15) were at a similar risk of UBC compared to never smokers who were never exposed to ETS. Results for males and females were similar. Also, when pooling all estimates during both childhood and adulthood, no effect was observed (SOR = 1.00, 95% CI = 0.89-1.10). : Although measurement of exposure to ETS was imprecise, there does not seem to be an association between UBC risk and exposure to ETS during childhood or adulthood. However, the current body of evidence mostly overlooks the duration and intensity of exposure to ETS.
主动吸烟是膀胱癌（UBC）的一个主要危险因素。然而，暴露于环境烟草烟雾（ETS）无论是在儿童期还是成年期，也与 UBC 风险相关的证据并不明确。通过本次荟萃分析，我们旨在总结 ETS 暴露与 UBC 风险之间的关联。
共有 11 项研究（3 项队列研究，8 项病例对照研究）纳入了本次荟萃分析，计算了从未吸烟但在儿童期家中、成年期家中或成年期工作环境中暴露于 ETS 的人群与从未暴露于 ETS 的人群相比患 UBC 的风险的汇总优势比（SOR）。进行了敏感性分析以检验结果的稳健性。
从未吸烟但在儿童期（SOR=1.04，95%置信区间（CI）=0.82-1.26）、成年期在工作中（SOR=0.98，95%CI=0.78-1.18）或在家中（SOR=0.99，95%CI=0.83-1.15）暴露于 ETS 的人群与从未暴露于 ETS 的人群相比，患 UBC 的风险相似。男性和女性的结果相似。此外，当汇总儿童期和成年期的所有估计值时，未观察到影响（SOR=1.00，95%CI=0.89-1.10）。
尽管 ETS 暴露的测量不够精确，但似乎不存在 UBC 风险与儿童期或成年期暴露于 ETS 之间的关联。然而，目前的证据主要忽略了 ETS 暴露的持续时间和强度。
