Wynder E L, Augustine A, Kabat G C, Hebert J R
American Health Foundation, Division of Epidemiology, New York, NY 10017.
Cancer. 1988 Feb 1;61(3):622-7. doi: 10.1002/1097-0142(19880201)61:3<622::aid-cncr2820610334>3.0.co;2-j.
The relationship between the type of cigarette smoked and bladder cancer risk was examined in data from a hospital-based case-control study. Information on smoking, including filtered and nonfiltered cigarette use, was available for 899 male and 427 female patients and 2713 male and 1243 female age-matched controls interviewed in 20 hospitals from nine cities in the US between 1969 and 1984. Smokers of filtered cigarettes had a slightly reduced risk of bladder cancer relative to smokers of nonfiltered cigarettes (odds ratio 0.64, 95% confidence interval 0.38 to 1.10 among male smokers; odds ratio 0.74, 95% confidence interval 0.37 to 1.48 among female smokers). In both sexes there was no statistically significant reduction in risk among switchers from nonfiltered to filtered cigarettes compared with lifetime nonfiltered cigarette smokers (odds ratio 0.93, 95% confidence interval 0.71 to 1.24 among male smokers; odds ratio 0.76, 95% confidence interval 0.40 to 1.46 among female smokers). The causal implications of these findings, in particular a possible initiation effect of tobacco smoke on bladder carcinogenesis, are discussed.
在美国九个城市的20家医院于1969年至1984年间对899名男性和427名女性患者以及2713名男性和1243名年龄匹配的女性对照进行访谈所获数据中，研究了所吸香烟类型与膀胱癌风险之间的关系。关于吸烟的信息，包括过滤嘴香烟和非过滤嘴香烟的使用情况，均有记录。相对于吸非过滤嘴香烟者，吸过滤嘴香烟者患膀胱癌的风险略有降低（男性吸烟者的优势比为0.64，95%置信区间为0.38至1.10；女性吸烟者的优势比为0.74，95%置信区间为0.37至1.48）。与终生吸非过滤嘴香烟者相比，从吸非过滤嘴香烟转为吸过滤嘴香烟者在两性中风险均未出现统计学上的显著降低（男性吸烟者的优势比为0.93，95%置信区间为0.71至1.24；女性吸烟者的优势比为0.76，95%置信区间为0.40至1.46）。本文讨论了这些发现的因果含义，尤其是烟草烟雾对膀胱癌发生可能的起始作用。
