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Title: Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis.
Austin Authors: O'Keeffe, Linda M;Taylor, Gemma;Huxley, Rachel R;Mitchell, Paul L R ;Woodward, Mark;Peters, Sanne A E
Affiliation: Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Epidemiology, John Hopkins University, Baltimore, Maryland, USA
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
The George Institute for Global Health, University of Oxford, Oxford, UK
MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
Department of Psychology, University of Bath, Bath, UK
College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
Issue Date: 3-Oct-2018 2018-10-03
Publication information: BMJ Open 2018; 8(10): e021611
Abstract: To investigate the sex-specific association between smoking and lung cancer. Systematic review and meta-analysis. 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. Cohort studies reporting the sex-specific relative risk (RR) of lung cancer associated with smoking. 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. 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.
DOI: 10.1136/bmjopen-2018-021611
ORCID: 0000-0003-2185-0162
PubMed URL: 30287668
Type: Journal Article
Subjects: lung cancer
systematic review
Appears in Collections:Journal articles

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