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Cited by 509Smoking Behavior and CessationLung Cancer Diagnosis and TreatmentOccupational and environmental lung diseases

Cigarette smoking and lung cancer—relative risk estimates for the major histological types from a pooled analysis of case–control studies

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Pesch, Beate, Kendzia, Benjamin, Gustavsson, Per, Jöckel, Karl‐Heinz, Johnen, Georg, Pohlabeln, Hermann, Olsson, Ann, Ahrens, Wolfgang +28 more·2012·International Journal of Cancer
DOI 10.1002/ijc.27339PMC PMC3296911
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Abstract

Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age‐adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8–143.2) for SqCC, 111.3 (95% CI: 69.8–177.5) for SCLC and 21.9 (95% CI: 16.6–29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5–124.6), 108.6 (95% CI: 50.7–232.8) and 16.8 (95% CI: 9.2–30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.

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  • The increased proportion of SCLC in the upper lobes may support the view that these lobes are most exposed to inhaled smoke.

    “The increased proportion of SCLC, the tumour with the strongest correlation to tobacco smoke [31], in the upper lobes may support the view that these lobes are most exposed to the inhaled smoke.”

    From Distribution and characteristics of malignant tumours by lung lobe (2024) · cites this paper as [31]

    The Discussion identifies SCLC and squamous cell carcinoma as the subtypes with the highest smoking-related risks. The Results do not establish SCLC as uniquely the most strongly associated: among women smoking at least 60 pack-years, the reported risk estimate is higher for squamous cell carcinoma than for SCLC. The citation is attached to the smoking-association description, not the statement about upper-lobe exposure. (LLM, conf=0.86)

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Authors
Pesch, B., Kendzia, B., Gustavsson, P., Jöckel, K., Johnen, G., Pohlabeln, H., Olsson, A., Ahrens, W., Gross, I. M., Brüske, I., Wichmann, H., Merletti, F., Richiardi, L., Simonato, L., Fortes, C., Siemiatycki, J., Parent, M., Consonni, D., Landi, M. T., Caporaso, N., Zaridze, D., Cassidy, A., Szeszenia‐Dabrowska, N., Rudnai, P., Lissowska, J., Stücker, I., Fabianova, E., Dumitru, R. S., Bencko, V., Foretova, L., Janout, V., Rudin, C. M., Brennan, P., Boffetta, P., Straif, K., & Brüning, T.
Affiliations
  • Institute for Prevention and Occupational Medicine (DE)
  • Karolinska Institutet (SE)
  • Essen University Hospital (DE)
  • University of Bremen (DE)
  • Helmholtz Munich (DE)
  • Piedmont Reference Center for Epidemiology and Cancer Prevention (IT)
  • University of Padua (IT)
  • Istituti di Ricovero e Cura a Carattere Scientifico (IT)
  • Université de Montréal (CA)
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
  • National Cancer Institute (US)
  • University of Liverpool (GB)
  • The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
  • Inserm (FR)
  • Institutul National de Sanatate Publica (RO)
  • Johns Hopkins University (US)
  • Centre international de recherche sur le cancer (FR)
  • International Prevention Research Institute (FR)
Corresponding author
Pesch, Beate
ORCID
Venue
International Journal of Cancer
Publisher
Wiley
Published
2011-12-14
Volume
131
Issue
5
Pages
1210-1219
ISSN
  • 0020-7136 (ISSN-L)
  • 1097-0215
DOI
10.1002/ijc.27339
PMC
PMC3296911
OpenAlex
W1979840121
Cited by
509
References
2
Citations by year
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FWCI
10.47
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • International Journal of Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
  • HAL (submittedVersion)
  • Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • EspaceINRS (National Institute for Scientific Research (Canada)) (submittedVersion)
  • Site cant be reached (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Funders
  • National Institutes of Health (Z99 CA999999)
  • Canadian Institutes of Health Research
  • National Cancer Institute (Y99 CA999999)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
Keywords
cigarette smoking, lung cancer, histological subtypes, squamous cell carcinoma, small cell lung cancer, adenocarcinoma, smoking cessation, relative risk, sex differences, dose-response relationship, pooled case-control analysis
MeSH terms
Adenocarcinoma, Adolescent, Adult, Canada, Carcinoma, Squamous Cell, Child, Europe, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Risk, Smoking, Prevalence, Case-Control Studies, Small Cell Lung Carcinoma, Young Adult

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