Shi Jiajun, Wen Wanqing, Cai Qiuyin, Shrubsole Martha J, Shu Xiao-Ou, Zheng Wei
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Epidemiology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251341523. doi: 10.1177/10732748251341523. Epub 2025 May 28.
IntroductionCigarette smoking and alcohol drinking are well-known risk factors for various cancers. We aimed to determine a comprehensive profile of cancer risk associated with these lifestyle factors in predominantly low-income Americans.MethodsWe prospectively investigated the associations between cigarette smoking, alcohol drinking, and the risk of twelve cancer types among over 74 000 low-income Black and White adults from the Southern Community Cohort Study in the United States. We used the Cox proportional hazards models to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for these associations.ResultsCompared to never smokers, current smokers had an increased HR for cancers of lung (HR: 14.14, 95% CI: 11.47-17.42), liver and bile duct (HR: 3.19, 95% CI: 2.40-4.25), kidney (HR: 1.47, 95% CI: 1.10-1.96), pancreas (HR: 1.88, 95% CI: 1.41-2.50), oral and pharynx (HR: 3.83, 95% CI: 2.70-5.42), and bladder (HR: 2.81, 95% CI: 1.92-4.11), and a reduced risk of prostate cancer (HR: 0.78, 95% CI: 0.68-0.89) and uterine cancer (HR: 0.45, 95% CI: 0.32-0.63); former smokers also exhibited elevated risks for cancers of lung, liver and bile duct, kidney, and bladder; however, a decreased risk for the lung, liver and bile duct, and bladder cancers was observed with longer durations of smoking cessation, with HRs from 9.71, 2.26, and 2.28 for a duration of <10 years down to 4.28, 1.58, and 1.42 for a duration of 10-19 years, respectively. Compared to never-drinkers, participants who consumed more than 2 drinks per day had increased risks of liver and bile duct cancer (HR: 1.66, 95% CI: 1.29-2.13) and oral and pharynx cancer (HR: 2.15, 95% CI: 1.58-2.91).ConclusionCigarette smoking and alcohol drinking were associated with an increased risk of multiple cancers. Our findings support efforts to control cigarette and alcohol consumption for cancer prevention in low-income U.S. populations.
引言
吸烟和饮酒是众所周知的多种癌症的风险因素。我们旨在确定在主要为低收入的美国人中，与这些生活方式因素相关的癌症风险的全面概况。
方法
我们对来自美国南方社区队列研究的74000多名低收入黑人和白人成年人中，吸烟、饮酒与12种癌症类型风险之间的关联进行了前瞻性调查。我们使用Cox比例风险模型来估计这些关联的风险比（HRs）和相应的95%置信区间（CIs）。
结果
与从不吸烟者相比，当前吸烟者患肺癌（HR：14.14，95%CI：11.47 - 17.42）、肝和胆管癌（HR：3.19，95%CI：2.40 - 4.25）、肾癌（HR：1.47，95%CI：1.10 - 1.96）、胰腺癌（HR：1.88，95%CI：1.41 - 2.50）、口腔和咽癌（HR：3.83，95%CI：2.70 - 5.42）以及膀胱癌（HR：2.81，95%CI：1.92 - 4.11）的风险增加，而患前列腺癌（HR：0.78，95%CI：0.68 - 0.89）和子宫癌（HR：0.45，95%CI：0.32 - 0.63）的风险降低；既往吸烟者患肺癌、肝和胆管癌、肾癌以及膀胱癌的风险也升高；然而，随着戒烟时间延长，肺癌、肝和胆管癌以及膀胱癌的风险降低，戒烟时间<10年时HR分别为9.71、2.26和2.28，戒烟时间为10 - 19年时分别降至4.28、1.58和1.42。与从不饮酒者相比，每天饮酒超过2杯的参与者患肝和胆管癌（HR：1.66，95%CI：1.29 - 2.13）以及口腔和咽癌（HR：2.15，95%CI：1.58 - 2.91）的风险增加。
结论
吸烟和饮酒与多种癌症风险增加相关。我们的研究结果支持在美国低收入人群中为预防癌症而控制香烟和酒精消费的努力。
