Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
Br J Cancer. 2024 Oct;131(7):1116-1125. doi: 10.1038/s41416-024-02732-5. Epub 2024 Jun 28.
Through the use of an innovative method to identify original publications, we conducted a meta-analysis of all epidemiological studies evaluating the association between second-hand smoke (SHS) exposure and breast cancer risk among female non-smokers published in English up to October 2022. Pooled relative risks (RR) were obtained through the use of random-effects models. Dose-response relationships were derived using log-linear functions. Out of 73 identified eligible studies, 63 original articles were included in the meta-analysis. The pooled RR for breast cancer for overall exposure to SHS was 1.24 (95% confidence interval, CI, 1.15-1.34, number of articles, n = 52). Regarding the setting of exposure, RRs were 1.17 (95% CI 1.08-1.27, n = 37) for SHS exposure at home, 1.03 (95% CI 0.98-1.08, n = 15) at the workplace, 1.24 (95% CI 1.11-1.37, n = 16) at home or workplace, and 1.45 (95% CI 1.16-1.80, n = 13) for non-specified settings. The risk of breast cancer increased linearly with higher duration (RR 1.29; 95% CI 1.04-1.59 for 40 years of SHS exposure, n = 12), intensity (RR 1.38; 95% CI 1.14-1.67 for 20 cigarettes of SHS exposure per day, n = 6), and pack-years (RR 1.50; 95% CI 0.92-2.45 for 40 SHS pack-years, n = 6) of SHS exposure. This meta-analysis shows a statistically significant excess risk of breast cancer in women exposed to SHS.
通过使用一种创新的方法来识别原始出版物,我们对截至 2022 年 10 月以英文发表的所有评估二手烟(SHS)暴露与女性非吸烟者乳腺癌风险之间关联的流行病学研究进行了荟萃分析。通过使用随机效应模型获得合并的相对风险(RR)。使用对数线性函数得出剂量-反应关系。在确定的 73 项合格研究中,有 63 项原始文章纳入荟萃分析。总体 SHS 暴露的乳腺癌合并 RR 为 1.24(95%置信区间,CI,1.15-1.34,文章数量,n=52)。关于暴露环境,家庭中 SHS 暴露的 RR 为 1.17(95%CI 1.08-1.27,n=37),工作场所为 1.03(95%CI 0.98-1.08,n=15),家庭或工作场所为 1.24(95%CI 1.11-1.37,n=16),未指定环境为 1.45(95%CI 1.16-1.80,n=13)。乳腺癌的风险随 SHS 暴露时间(RR 1.29;40 年 SHS 暴露,n=12)、强度(RR 1.38;每天 20 支 SHS 暴露,n=6)和包年(RR 1.50;40 年 SHS 暴露,n=6)的增加而呈线性增加。这项荟萃分析表明,暴露于 SHS 的女性乳腺癌风险存在统计学上显著的超额风险。