Document Detail

Tobacco smoking and the risk of upper aero-digestive tract cancers: A reanalysis of case-control studies using spline models.
MedLine Citation:
PMID:  18224689     Owner:  NLM     Status:  MEDLINE    
Although tobacco smoking has long been recognized as a major risk factor for cancer of the upper aero-digestive tract (UADT, i.e., oral cavity, pharynx, larynx, and oesophagus), very few studies have provided estimates of the effect of very low tobacco consumption. Step-functions have been the common statistical methods for risk estimates, but the choice of reference category and of interval cutpoints influence the results, especially when data are sparse. In the present analysis, the dose-response relationship between UADT cancers and tobacco smoking was evaluated through logistic regression spline models. We included 1,241 UADT male cases and 2,835 male controls pooled from a large series of case-control studies conducted in northern Italy and in the Swiss Canton of Vaud during the last 2 decades. For cancers of the pharynx, larynx and oesophagus, the risk steadily increased with number of cigarettes/day. The risk of oral, pharyngeal and oesophageal cancers was significantly higher in smokers than in nonsmokers beginning with as low as 2 cigarettes/day. The effect of tobacco smoking at low levels seemed less evident for laryngeal cancer since the raise in risk begun with 6 cigarettes/day. In conclusion, for all the examined UADT sites, a monotonic dose-response relationship between cancer risk and cigarette smoking emerged. The excess of risk among people smoking 2 cigarettes/day highlights the absence of any harmless level for cigarette smoking, and it further supports the need of public health programs against tobacco smoking.
Jerry Polesel; Renato Talamini; Carlo La Vecchia; Fabio Levi; Luigi Barzan; Diego Serraino; Silvia Franceschi; Luigino Dal Maso
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  122     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-03-24     Completed Date:  2008-04-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2398-402     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Italy.
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MeSH Terms
Case-Control Studies
Esophageal Neoplasms / etiology*
Laryngeal Neoplasms / etiology*
Middle Aged
Models, Biological*
Mouth Neoplasms / etiology*
Pharyngeal Neoplasms / etiology*
Risk Factors
Smoking / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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