Cigarette smoking, educational level and total and site-specific cancer: a cohort study in men in Lithuania

Smoking is an established risk factor for cancer. However, most studies have been carried out on western populations, and less is known about the impact in central and eastern Europe. Our objective was to investigate the association between cigarette smoking, educational level and risk of cancer in...

Full description

Saved in:
Bibliographic Details
Published in:European journal of cancer prevention 2014-11, Vol.23 (6), p.579-586
Main Authors: Everatt, Rūta, Kuzmickienė, Irena, Virvičiūtė, Dalia, Tamošiūnas, Abdonas
Format: Article
Language:English
Subjects:
Adult
Alcohol Drinking - epidemiology
Cohort Studies
Educational Status
Humans
Incidence
Lithuania - epidemiology
Male
Middle Aged
Neoplasms - epidemiology
Neoplasms - pathology
Research paper
Smoking - epidemiology
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Smoking is an established risk factor for cancer. However, most studies have been carried out on western populations, and less is known about the impact in central and eastern Europe. Our objective was to investigate the association between cigarette smoking, educational level and risk of cancer in a Lithuanian population-based cohort study. The study included 6976 men initially free from cancer. During the follow-up (1978–2008), 1780 cancer cases were identified. Cox proportional hazards models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs). In addition, the burden of cancer attributable to smoking was assessed by the population attributable fraction. Following adjustment for age, education, alcohol consumption and BMI, for current compared with never smokers, highly significant and strongly elevated estimates were found for total (HR=1.79, 95% CI 1.59–2.02), tobacco-related (HR=2.52, 95% CI 2.16–2.95), upper aerodigestive tract (UADT) (HR=5.77, 95% CI 2.73–12.21), lung (HR=10.47, 95% CI 6.74–16.25), bladder (HR=3.31, 95% CI 1.71–6.41) and liver (HR=4.64, 95% CI 1.53–14.08) cancer. Findings suggest a lower risk of prostate cancer in current smokers. In addition, the occurrence of lung and UADT cancer was significantly elevated in men in the lowest educational attainment category. If smoking had not occurred, ~ 23% of total cancer, 37% of tobacco-related, 77% of lung, 58% of UADT, 43% of liver and 45% of bladder cancer cases could have been prevented in this cohort of men. Cancer-control strategies focused on reducing smoking should be a public health priority.
ISSN:0959-8278
1473-5709
DOI:10.1097/CEJ.0000000000000018