Chow W H, Hsing A W, McLaughlin J K, Fraumeni J F
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
Cancer Epidemiol Biomarkers Prev. 1996 Feb;5(2):79-80.
Adrenal cancer is a rare and heterogenous group of tumors the etiology of which is largely unknown. Tobacco use was suggested as a potential risk factor in a recent case-control study of adults dying from adrenal cancers, most of which were adrenocortical carcinomas. In a cohort study of nearly 250,000 United States veterans whose mortality was followed for up to 26 years, we evaluated the risk of adrenal cancer associated with tobacco use. Relative risks and corresponding 95% confidence intervals were calculated. A total of 27 adrenal cancer deaths were observed during the follow-up period. Relative to nonusers of any tobacco, risk was elevated 5-fold (relative risk = 5.1; confidence interval = 1.1-22.4) among current cigarette smokers, with risks further increased among those who smoked > 20 cigarettes/day (P for trend < 0.01). Nonsignificant increases in risk occurred among smokers of other forms of tobacco. This cohort study provides support for an etiological relationship between tobacco smoking and adrenal cancer, although further confirmatory studies are needed.
肾上腺癌是一组罕见且异质性的肿瘤，其病因大多不明。在最近一项针对死于肾上腺癌（其中大多数为肾上腺皮质癌）的成年人的病例对照研究中，吸烟被认为是一种潜在风险因素。在一项对近25万名美国退伍军人进行的队列研究中，对他们长达26年的死亡率进行了跟踪，我们评估了吸烟与肾上腺癌相关的风险。计算了相对风险和相应的95%置信区间。在随访期间共观察到27例肾上腺癌死亡病例。与不使用任何烟草的人相比，当前吸烟者患肾上腺癌的风险升高了5倍（相对风险=5.1；置信区间=1.1 - 22.4），每天吸烟超过20支的人风险进一步增加（趋势P值<0.01）。其他形式烟草吸烟者的风险虽有增加但不显著。尽管还需要进一步的验证性研究，但这项队列研究为吸烟与肾上腺癌之间的病因关系提供了支持。
