挪威妇女与癌症研究（NOWAC）中归因于吸烟的肺癌比例。
The fraction of lung cancer attributable to smoking in the Norwegian Women and Cancer (NOWAC) Study.
机构信息
Faculty of Health Sciences, Department of Community Medicine, The UiT Arctic University of Norway, Tromsø, Norway.
出版信息
Br J Cancer. 2021 Feb;124(3):658-662. doi: 10.1038/s41416-020-01131-w. Epub 2020 Oct 27.
BACKGROUND
We examined the association between active and passive smoking and lung cancer risk and the population attributable fraction (PAF) of lung cancer due to active smoking, in the Norwegian Women and Cancer Study, a nationally representative prospective cohort study.
METHODS
We followed 142,508 women, aged 31-70 years, who completed a baseline questionnaire between 1991 and 2007, through linkages to national registries through December 2015. We used Cox proportional hazards models, to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). We calculated PAF to indicate what proportion of lung cancer cases could have been prevented in the absence of smoking.
RESULTS
During the more than 2.3 million person-years of observation, we ascertained 1507 lung cancer cases. Compared with never smokers, current (HR 13.88, 95% CI 10.18-18.91) smokers had significantly increased risk of lung cancer. Female never smokers exposed to passive smoking had a 1.3-fold (HR 1.34, 95% CI 0.89-2.01) non- significantly increased risk of lung cancer, compared with never smokers. The PAF of lung cancer was 85.3% (95% CI 80.0-89.2).
CONCLUSION
More than 8 in 10 lung cancer cases could have been avoided in Norway, if the women did not smoke.
背景
我们研究了主动吸烟和被动吸烟与肺癌风险的关系，以及因主动吸烟导致的肺癌人群归因分数（PAF），这是一项全国代表性的前瞻性队列研究。
方法
我们对 142508 名年龄在 31-70 岁的女性进行了随访，这些女性在 1991 年至 2007 年期间完成了基线问卷调查，并通过与国家登记处的链接，截至 2015 年 12 月进行了随访。我们使用 Cox 比例风险模型，估计风险比（HR）及其 95%置信区间（CI）。我们计算了 PAF，以表明在没有吸烟的情况下，肺癌病例中有多少比例可以预防。
结果
在超过 230 万个人年的观察期间，我们确定了 1507 例肺癌病例。与从不吸烟者相比，当前吸烟者（HR 13.88，95%CI 10.18-18.91）的肺癌风险显著增加。与从不吸烟者相比，女性从不吸烟者暴露于被动吸烟，肺癌风险增加了 1.3 倍（HR 1.34，95%CI 0.89-2.01），但无统计学意义。肺癌的 PAF 为 85.3%（95%CI 80.0-89.2）。
结论
如果这些女性不吸烟，挪威 80%以上的肺癌病例是可以避免的。
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