Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis
Objectives To investigate the sex-specific association between smoking and lung cancer.Design Systematic review and meta-analysis.Data sources We searched PubMed and EMBASE from 1 January 1999 to 15 April 2016 for cohort studies. Cohort studies before 1 January 1999 were retrieved from a previous me...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2018-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/10/e021611.full |
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| _version_ | 1825208863831359488 |
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| author | Sanne A E Peters Mark Woodward Paul Mitchell Rachel R Huxley Gemma Taylor Linda M O’Keeffe |
| author_facet | Sanne A E Peters Mark Woodward Paul Mitchell Rachel R Huxley Gemma Taylor Linda M O’Keeffe |
| author_sort | Sanne A E Peters |
| collection | DOAJ |
| description | Objectives To investigate the sex-specific association between smoking and lung cancer.Design Systematic review and meta-analysis.Data sources We searched PubMed and EMBASE from 1 January 1999 to 15 April 2016 for cohort studies. Cohort studies before 1 January 1999 were retrieved from a previous meta-analysis. Individual participant data from three sources were also available to supplement analyses of published literature.Eligibility criteria for selecting studies Cohort studies reporting the sex-specific relative risk (RR) of lung cancer associated with smoking.Results Data from 29 studies representing 99 cohort studies, 7 million individuals and >50 000 incident lung cancer cases were included. The sex-specific RRs and their ratio comparing women with men were pooled using random-effects meta-analysis with inverse-variance weighting. The pooled multiple-adjusted lung cancer RR was 6.99 (95% Confidence Interval (CI) 5.09 to 9.59) in women and 7.33 (95% CI 4.90 to 10.96) in men. The pooled ratio of the RRs was 0.92 (95% CI 0.72 to 1.16; I2=89%; p<0.001), with no evidence of publication bias or differences across major pre-defined participant and study subtypes. The women-to-men ratio of RRs was 0.99 (95% CI 0.65 to 1.52), 1.11 (95% CI 0.75 to 1.64) and 0.94 (95% CI 0.69 to 1.30), for light, moderate and heavy smoking, respectively.Conclusions Smoking yields similar risks of lung cancer in women compared with men. However, these data may underestimate the true risks of lung cancer among women, as the smoking epidemic has not yet reached full maturity in women. Continued efforts to measure the sex-specific association of smoking and lung cancer are required. |
| format | Article |
| id | doaj-art-70df881f3c6347d7b709fedae6d7efdd |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-70df881f3c6347d7b709fedae6d7efdd2025-02-06T18:55:09ZengBMJ Publishing GroupBMJ Open2044-60552018-10-0181010.1136/bmjopen-2018-021611Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysisSanne A E Peters0Mark Woodward1Paul Mitchell2Rachel R Huxley3Gemma Taylor4Linda M O’Keeffe52 The George Institute for Global Health, School of Public Health, Imperial College London, London, UK6 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia1 Westmead Institute for Medical Research, Westmead, New South Wales, AustraliaLa Trobe University College of Science, Health and Engineering, Melbourne, Victoria, Australia1 MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UKSchool of Public Health, University College Cork, Cork, IrelandObjectives To investigate the sex-specific association between smoking and lung cancer.Design Systematic review and meta-analysis.Data sources We searched PubMed and EMBASE from 1 January 1999 to 15 April 2016 for cohort studies. Cohort studies before 1 January 1999 were retrieved from a previous meta-analysis. Individual participant data from three sources were also available to supplement analyses of published literature.Eligibility criteria for selecting studies Cohort studies reporting the sex-specific relative risk (RR) of lung cancer associated with smoking.Results Data from 29 studies representing 99 cohort studies, 7 million individuals and >50 000 incident lung cancer cases were included. The sex-specific RRs and their ratio comparing women with men were pooled using random-effects meta-analysis with inverse-variance weighting. The pooled multiple-adjusted lung cancer RR was 6.99 (95% Confidence Interval (CI) 5.09 to 9.59) in women and 7.33 (95% CI 4.90 to 10.96) in men. The pooled ratio of the RRs was 0.92 (95% CI 0.72 to 1.16; I2=89%; p<0.001), with no evidence of publication bias or differences across major pre-defined participant and study subtypes. The women-to-men ratio of RRs was 0.99 (95% CI 0.65 to 1.52), 1.11 (95% CI 0.75 to 1.64) and 0.94 (95% CI 0.69 to 1.30), for light, moderate and heavy smoking, respectively.Conclusions Smoking yields similar risks of lung cancer in women compared with men. However, these data may underestimate the true risks of lung cancer among women, as the smoking epidemic has not yet reached full maturity in women. Continued efforts to measure the sex-specific association of smoking and lung cancer are required.https://bmjopen.bmj.com/content/8/10/e021611.full |
| spellingShingle | Sanne A E Peters Mark Woodward Paul Mitchell Rachel R Huxley Gemma Taylor Linda M O’Keeffe Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis BMJ Open |
| title | Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis |
| title_full | Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis |
| title_fullStr | Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis |
| title_full_unstemmed | Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis |
| title_short | Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis |
| title_sort | smoking as a risk factor for lung cancer in women and men a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/8/10/e021611.full |
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