Anderson K E, Woo C, Olson J E, Sellers T A, Zheng W, Kushi L H, Folsom A R
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
Cancer Epidemiol Biomarkers Prev. 1997 Jun;6(6):401-5.
A family history of cervical, ovarian, or uterine cancer has been shown to be associated with increased lung cancer risk among postmenopausal women. The present report examines the hypotheses that a family history of cervical cancer is positively associated with histological subtypes of lung cancer most strongly associated with smoking and that a family history of ovarian or uterine cancer are positively associated with risk of adenocarcinoma of the lung. Data are from the Iowa Women's Health Study, a prospective cohort study of 34,480 women ages 55-69 in 1986. Personal smoking histories, use of alcohol, and family history of selected cancers in first- and second-degree relatives were collected at baseline. Follow-up for cancer occurrence was achieved through the State Health Registry of Iowa. After baseline exclusions, a total of 343 incident lung cancers were identified in the cohort at risk through 1994. Women with a family history of cervical cancer in a first-degree relative had a multivariate-adjusted relative risk of lung cancer of 1.6 [95% confidence interval (CI): 0.98-2.6] compared to women without a family history. The risk was particularly high for malignancies most strongly associated with smoking (squamous, small cell, and large cell tumors; relative risk, 2.0; 95% CI, 1.1-3.7). Consistent with our hypotheses, a family history of ovarian cancer was associated with an approximately 2-fold increased risk (multivariate adjusted) of adenocarcinoma of the lung; the association with malignancies more strongly associated with smoking was inverse (relative risk, 0.6; 95% CI, 0.2-2.4). A family history of uterine cancer was not associated with adenocarcinoma, but there was a positive association observed for the most strongly smoking-associated histological types. These results suggest that a family history of cervical cancer is a modest independent risk factor for lung cancers most strongly associated with smoking, and a family history of ovarian cancer is a risk factor for adenocarcinoma of the lung.
宫颈癌、卵巢癌或子宫癌家族史已被证明与绝经后女性患肺癌风险增加有关。本报告检验了以下假设：宫颈癌家族史与与吸烟关系最为密切的肺癌组织学亚型呈正相关，卵巢癌或子宫癌家族史与肺腺癌风险呈正相关。数据来自爱荷华州女性健康研究，这是一项对1986年34480名年龄在55 - 69岁女性进行的前瞻性队列研究。在基线时收集了个人吸烟史、饮酒情况以及一级和二级亲属中特定癌症的家族史。通过爱荷华州州立健康登记处对癌症发生情况进行随访。经过基线排除后，到1994年，在有风险的队列中总共确定了343例新发肺癌病例。与没有家族史的女性相比，一级亲属中有宫颈癌家族史的女性患肺癌的多变量调整相对风险为1.6[95%置信区间（CI）：0.98 - 2.6]。与吸烟关系最为密切的恶性肿瘤（鳞状细胞癌（鳞癌）、小细胞癌和大细胞癌；相对风险为2.0；95% CI为1.1 - 3.7）的风险尤其高。与我们的假设一致，卵巢癌家族史与肺腺癌的多变量调整风险增加约2倍相关；与吸烟关系更密切的恶性肿瘤的关联则相反（相对风险为0.6；95% CI为0.2 - 2.4）。子宫癌家族史与肺腺癌无关，但在与吸烟关系最为密切的组织学类型中观察到正相关。这些结果表明，宫颈癌家族史是与吸烟关系最为密切的肺癌的一个适度独立危险因素，卵巢癌家族史是肺腺癌的一个危险因素。
