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Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium

JM. Ordóñez-Mena, B. Schöttker, U. Mons, M. Jenab, H. Freisling, B. Bueno-de-Mesquita, MG. O'Doherty, A. Scott, F. Kee, BH. Stricker, A. Hofman, CE. de Keyser, R. Ruiter, S. Söderberg, P. Jousilahti, K. Kuulasmaa, ND. Freedman, T. Wilsgaard, LC....

. 2016 ; 14 (-) : 62. [pub] 20160405

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, metaanalýza, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc17000297

BACKGROUND: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. METHODS: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. RESULTS: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. CONCLUSIONS: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.

Department Epidemiology and Public Health University College London London UK

Department of Chronic Diseases National Institute for Public Health and the Environment Bilthoven The Netherlands Department of Gastroenterology and Hepatology University Medical Centre Utrecht The Netherlands Division of Epidemiology and Biostatistics the School of Public Health Imperial College London London United Kingdom Department of Social and Preventive Medicine Faculty of Medicine University of Malaya Kuala Lumpur Malaysia

Department of Community Medicine UiT The Arctic University of Norway Tromsø Norway

Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands

Department of Public Health and Clinical Medicine Cardiology and Heart Center Umeå University Umeå Sweden

Diet Genes and Environment Danish Cancer Society Research Center Copenhagen Denmark

Division of Clinical Epidemiology and Aging Research German Cancer Research Center Im Neuenheimer Feld 581 D 69120 Heidelberg Germany

Division of Human Nutrition Wageningen University Wageningen The Netherlands

Hellenic Health Foundation Athens Greece

Hellenic Health Foundation Athens Greece Institute for Translational Epidemiology and Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York NY USA

Hellenic Health Foundation Athens Greece University of Athens Medical School Department of Hygiene Epidemiology and Medical Statistics Athens Greece

Institute of Cardiology of Lithuanian University of Health Sciences Kaunas Lithuania

Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden

Institute of Internal and Preventive Medicine Novosibirsk Russia

International Agency for Research on Cancer Lyon France

Jagiellonian University Medical College Faculty of Health Sciences Krakow Poland

National Institute for Health and Welfare Helsinki Finland

National Institute of Public Health Prague Czech Republic

Network Aging Research Heidelberg Germany

Network Aging Research Im Neuenheimer Feld 581 D 69120 Heidelberg Germany

Nutritional Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD USA

Nutritional Research Department of Public Health and Clinical Medicine and Arcum Arctic Research Centre at Umeå University Umeå Sweden

UKCRC Centre of Excellence for Public Health Queens University of Belfast Belfast UK

University of Athens Medical School Department of Hygiene Epidemiology and Medical Statistics Athens Greece

Citace poskytuje Crossref.org

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$a BACKGROUND: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. METHODS: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. RESULTS: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. CONCLUSIONS: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.
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