Hegmann K T, Fraser A M, Keaney R P, Moser S E, Nilasena D S, Sedlars M, Higham-Gren L, Lyon J L
Department of Family and Preventive Medicine, University of Utah, Salt Lake City 84132.
Epidemiology. 1993 Sep;4(5):444-8. doi: 10.1097/00001648-199309000-00010.
It has been assumed that a younger age at initiation of cigarette smoking is associated with an increased risk of lung cancer, but previous studies have not adjusted for two strong risk factors, the amount smoked and duration smoked. We used data from a population-based case-control study with 282 histologically confirmed lung cancer cases matched to 3,282 random controls to determine whether age at initiation of smoking plays an independent role in the occurrence of lung cancer. After controlling for age, sex, and amount of tobacco exposure, men who began to smoke before age 20 had a substantially higher risk of developing lung cancer [odds ratio (OR) = 12.7; 95% confidence interval (CI) = 6.39-25.2] compared with men who began smoking at age 20 or older (OR = 6.03; 95% CI = 2.82-12.9). For women, the heavy increase in risk continued until age 25 (OR = 9.97; 95% CI = 4.68-21.2) compared with women who began smoking at age 26 or older (OR = 2.58; 95% CI = 0.53-12.4). There was no predisposition toward a specific histologic type of lung cancer. In this study, up to 52.4% of lung cancer cases in men and up to 73.0% of lung cancer cases in women could be attributed to this effect of early age of first smoking.
人们一直认为，开始吸烟的年龄较小与患肺癌风险增加有关，但以往的研究没有对两个强有力的风险因素，即吸烟量和吸烟持续时间进行调整。我们使用了一项基于人群的病例对照研究的数据，该研究中有282例经组织学确诊的肺癌病例与3282例随机对照进行匹配，以确定开始吸烟的年龄在肺癌发生中是否起独立作用。在控制了年龄、性别和烟草暴露量之后，与20岁及以上开始吸烟的男性相比，20岁之前开始吸烟的男性患肺癌的风险显著更高[比值比（OR）=12.7；95%置信区间（CI）=6.39 - 25.2]（OR = 6.03；95% CI = 2.82 - 12.9）。对于女性而言，与26岁及以上开始吸烟的女性相比，风险大幅增加一直持续到25岁（OR = 9.97；95% CI = 4.68 - 21.2）（OR = 2.58；95% CI = 0.53 - 12.4）。对特定组织学类型的肺癌没有易感性。在本研究中，男性肺癌病例中高达52.4%以及女性肺癌病例中高达73.0%可归因于首次吸烟年龄早的这种影响。
