TY - JOUR
T1 - Quantification of the smoking-associated cancer risk with rate advancement periods
T2 - Meta-analysis of individual participant data from cohorts of the CHANCES consortium
AU - Ordóñez-Mena, José Manuel
AU - Schöttker, Ben
AU - Mons, Ute
AU - Jenab, Mazda
AU - Freisling, Heinz
AU - Bueno-de-Mesquita, Bas
AU - O'Doherty, Mark G.
AU - Scott, Angela
AU - Kee, Frank
AU - Stricker, Bruno H.
AU - Hofman, Albert
AU - de Keyser, Catherine E.
AU - Ruiter, Rikje
AU - Söderberg, Stefan
AU - Jousilahti, Pekka
AU - Kuulasmaa, Kari
AU - Freedman, Neal D.
AU - Wilsgaard, Tom
AU - de Groot, Lisette C.P.G.M.
AU - Kampman, Ellen
AU - Håkansson, Niclas
AU - Orsini, Nicola
AU - Wolk, Alicja
AU - Nilsson, Lena Maria
AU - Tjønneland, Anne
AU - Pajak, Andrzej
AU - Malyutina, Sofia
AU - Kubínová, Růžena
AU - Tamosiunas, Abdonas
AU - Bobak, Martin
AU - Katsoulis, Michail
AU - Orfanos, Philippos
AU - Boffetta, Paolo
AU - Trichopoulou, Antonia
AU - Brenner, Hermann
PY - 2016
Y1 - 2016
N2 - Background: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. Methods: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. Results: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. Conclusions: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.
AB - Background: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. Methods: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. Results: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. Conclusions: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.
KW - Cancer
KW - Cohort
KW - Incidence
KW - Meta-analysis
KW - Mortality
KW - Smoking
U2 - 10.1186/s12916-016-0607-5
DO - 10.1186/s12916-016-0607-5
M3 - Article
AN - SCOPUS:84962159195
SN - 1741-7015
VL - 14
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 62
ER -
