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Lung cancer and cigarette smoking in Europe: An update of risk estimates and an assessment of inter‐country heterogeneity
Author(s) -
Simonato Lorenzo,
Agudo Antonio,
Ahrens Wolfgang,
Benhamou Ellen,
Benhamou Simone,
Boffetta Paolo,
Brennan Paul,
Darby Sarah C.,
Forastiere Francesco,
Fortes Cristina,
Gaborieau Valérie,
Gerken Michael,
Gonzales Carlos A.,
Jöckel KarlHeinz,
Kreuzer Michaela,
Merletti Franco,
Nyberg Fredrik,
Pershagen Göran,
Pohlabeln Hermann,
Rösch Franz,
Whitley Elise,
Wichmann HeinzErich,
Zambon Paola
Publication year - 2001
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/1097-0215(200102)9999:9999<::aid-ijc1139>3.0.co;2-7
Subject(s) - lung cancer , medicine , confounding , odds ratio , environmental health , tobacco smoke , demography , smoke , population , cancer , attributable risk , case control study , geography , sociology , meteorology
Ten case‐control studies have been carried out in 6 European countries to investigate the major risk factors for lung cancer. Carcinogenic effect from cigarette smoke was the most relevant interest in our study, which has included 7,609 cases of lung cancer and 10,431 controls, mainly population based. The results indicate elevated odds ratios (ORs; 23.9 among men and 8.7 among women) with attributable risks exceeding 90% for men and close to 60% for women. A large, and statistically significant, variability of the results across countries was detected after adjusting for the most common confounding variables, and after controlling, at least in part, for the instability of the ORs due to the small number of non‐smokers in some of the study subsets. This pattern of lung cancer risk associated with cigarettes smoke, across different European regions, reflects inherent characteristics of the studies as well as differences in smoking habits, particularly calender periods of starting, and it is likely to have been influenced by effect modifiers like indoor radon exposure, occupation, air pollution and dietary habits. © 2001 Wiley‐Liss, Inc.