De Stefani E, Barrios E, Fierro L
Departamento de Epidemiología, Instituto Nacional de Oncología, Montevideo.
Eur J Cancer. 1993;29A(5):763-6. doi: 10.1016/s0959-8049(05)80363-6.
Relative risks of oesophageal cancer for smoking were higher in communities smoking mainly black tobacco, when compared with results from populations comprising mainly users of blond tobacco. Also, hand-rolled cigarette smoking, which could be considered as a proxy indicator of black tobacco smoking, was also associated with higher risk of oesophageal cancer, in comparison with the use of commercial (manufactured) cigarettes. Finally, the use of pipes and cigars showed odds ratios of higher magnitude than those associated with cigarettes. This indirect evidence of a higher risk of oesophageal cancer due to the use of black products was confirmed in three recent hospital-based case-control studies. These investigations were able to compare the effect of both types of tobacco; relative risks for black tobacco were two to three times higher than risks associated with blond tobacco smoking, after controlling for major potential confounders. Laboratory evidence suggests that swallowing tobacco condensates could be a major risk factor for oesophageal cancer. Also, the higher content of tobacco-specific N-nitroso compounds in black tobacco, including organospecific substances, could explain its higher carcinogenic effect on the oesophageal mucosa.
与主要使用浅色烟草的人群相比，在主要吸食深色烟草的社区中，吸烟导致食管癌的相对风险更高。此外，与吸食商业（机制）卷烟相比，手卷烟吸食可被视为深色烟草吸食的一个替代指标，它也与较高的食管癌风险相关。最后，使用烟斗和雪茄的比值比高于与卷烟相关的比值比。最近三项基于医院的病例对照研究证实了使用深色烟草制品导致食管癌风险更高的这一间接证据。这些调查能够比较两种烟草的影响；在控制了主要潜在混杂因素后，深色烟草的相对风险比浅色烟草吸食相关风险高两到三倍。实验室证据表明，吞咽烟草冷凝物可能是食管癌的一个主要危险因素。此外，深色烟草中烟草特异性N-亚硝胺化合物含量较高，包括器官特异性物质，这可以解释其对食管黏膜具有更高的致癌作用。
