电子烟使用者中的癌症患病率：一项回顾性横断面美国国家健康与营养检查调查研究

Cancer Prevalence in E-Cigarette Users: A Retrospective Cross-Sectional NHANES Study.

作者信息

Chidharla Anusha, Agarwal Kriti, Abdelwahed Salwa, Bhandari Renu, Singh Abhishek, Rabbani Rizwan, Patel Kajal, Singh Priyanka, Mehta Deep, Manaktala Pritika S, Pillai Shreejith, Gupta Sachin, Koritala Thoyaja

机构信息

Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA.

These authors contributed equally to this article.

出版信息

World J Oncol. 2022 Feb;13(1):20-26. doi: 10.14740/wjon1438. Epub 2022 Feb 8.

DOI:10.14740/wjon1438

PMID:35317331

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8913014/

Abstract

BACKGROUND

It is well known that traditional smoking causes various types of cancer, leading to the current decline in traditional smoking among US adults from 20.9% in 2005 to 14.0% in 2019. Electronic cigarettes (e-cigarettes) are commonly marketed as a safe alternative and gaining popularity especially among never-smokers and adolescents. However, there is limited evidence of effects of e-cigarette on cancer. Hence, we aim to find the prevalence and association of e-cigarette and traditional smoking among cancer respondents.

METHODS

We conducted a retrospective cross-sectional study using the NHANES database from 2015 to 2018. We assessed history of cancer (MCQ220), type of cancers (MCQ230a), and smoking status (e-cigarette: SMQ900 or SMQ905 and traditional smoking: SMQ020) using questionnaires. We performed multivariable logistic regression models to find the association of e-cigarette use, traditional smoking, and no smoking with cancer after adjusting for confounding variables.

RESULTS

A total of 154,856 participants were included, of whom 5% were e-cigarette users, 31.4% were traditional smokers, and 63.6% were nonsmokers. There is a higher prevalence of e-cigarette use among younger participants, females (49 vs. 38) in comparison to traditional smokers (P < 0.0001). The e-cigarette users have lower prevalence of cancer compared to traditional smoking (2.3% vs. 16.8%; P < 0.0001), but they were diagnosed with cancer at a younger age. Among cancer subtypes, cervical cancer (22 vs. 2.6), leukemia (8.5 vs. 1.1), skin cancer (non-melanoma) (15.6 vs. 12.3), skin (other) (28 vs. 10) and thyroid (10.6 vs. 2.4) had higher prevalence of e-cigarette use compared to traditional smokers (P < 0.0001). Our regression analysis showed that e-cigarette users have 2.2 times higher risk of having cancer compared to non-smokers (odds ratio (OR): 2.2; 95% confidence interval (CI): 2.2 - 2.3; P < 0.0001). Similarly, traditional smokers have 1.96 higher odds of having cancer compared to nonsmokers (OR: 1.96; 95% CI: 1.96 - 1.97; P < 0.0001).

CONCLUSION

In our study, e-cigarette users had an early age of cancer onset and higher risk of cancer. Hence, this is stepping stone for future research to evaluate the safety and effects of e-cigarettes in patients with cancer.

摘要

背景

众所周知，传统吸烟会引发各类癌症，这导致美国成年人中传统吸烟率从2005年的20.9%降至2019年的14.0%。电子烟通常作为一种安全的替代品进行销售，尤其在从不吸烟者和青少年中越来越受欢迎。然而，关于电子烟对癌症影响的证据有限。因此，我们旨在找出癌症受访者中电子烟与传统吸烟的流行情况及关联。

方法

我们使用2015年至2018年的美国国家健康与营养检查调查（NHANES）数据库进行了一项回顾性横断面研究。我们通过问卷评估癌症病史（MCQ220）、癌症类型（MCQ230a）和吸烟状况（电子烟：SMQ900或SMQ905；传统吸烟：SMQ020）。我们进行了多变量逻辑回归模型，以在调整混杂变量后找出使用电子烟、传统吸烟和不吸烟与癌症之间的关联。

结果

总共纳入了154,856名参与者，其中5%是电子烟使用者，31.4%是传统吸烟者，63.6%是非吸烟者。与传统吸烟者相比，年轻参与者和女性（49%对38%）中电子烟使用者的比例更高（P < 0.0001）。与传统吸烟相比，电子烟使用者的癌症患病率较低（2.3%对16.8%；P < 0.0001），但他们被诊断出癌症的年龄更小。在癌症亚型中，与传统吸烟者相比，宫颈癌（22%对2.6%）、白血病（8.5%对1.1%）、皮肤癌（非黑色素瘤）（15.6%对12.3%）、其他皮肤癌（28%对10%）和甲状腺癌（10.6%对2.4%）的电子烟使用率更高（P < 0.0001）。我们的回归分析表明，与不吸烟者相比，电子烟使用者患癌症的风险高2.2倍（优势比（OR）：2.2；95%置信区间（CI）：2.2 - 2.3；P < 0.0001）。同样，与不吸烟者相比，传统吸烟者患癌症的几率高1.96倍（OR：1.96；95% CI：1.96 - 1.97；P < 0.0001）。