Lung cancer and cigarette smoking in women: A multicenter case‐control study in Europe

• Published in: International journal of cancer 2000-12, Vol.88 (5), p.820-827
• Main Authors: Agudo, Antonio, Ahrens, Wolfgang, Benhamou, Ellen, Benhamou, Simone, Boffetta, Paolo, Darby, Sarah C., Forastiere, Francesco, Fortes, Cristina, Gaborieau, Valérie, González, Carlos A., Jöckel, Karl‐Heinz, Kreuzer, Michaela, Merletti, Franco, Pohlabeln, Hermann, Richiardi, Lorenzo, Whitley, Elise, Wichmann, Heinz‐Erich, Zambon, Paola, Simonato, Lorenzo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Case-Control Studies; Europe - epidemiology; Female; Humans; Lung Neoplasms - epidemiology; Lung Neoplasms - etiology; Medical sciences; Middle Aged; Odds Ratio; Pneumology; Risk Factors; Smoking - adverse effects; Tumors of the respiratory system and mediastinum; Women's Health
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/1097-0215(20001201)88:5<820::AID-IJC21>3.0.CO;2-J

The association between cigarette smoking and lung cancer risk in women was investigated within the framework of a case‐control study in 9 centres from 6 European countries. Cases were 1,556 women up to 75 years of age with histologically confirmed primary lung cancer; 2,450 controls with age distribution similar to cases were selected. The predominant cell type was adenocarcinoma (33.5%), with similar proportions for squamous‐cell type (26.4%) and small‐cell carcinoma (22.3%). Overall, smoking cigarettes at any time was associated with a 5‐fold increase in lung cancer risk (odds ratio 5.21, 95% confidence interval 4.49–6.04); corresponding figures for current smoking habits were 8.94, 7.54–10.6. The association showed a dose‐response relationship with duration of the habit and daily and cumulative lifetime smoking. A significant excess risk of 70% was associated with every 10 pack‐years smoked. After 10 years of smoking cessation, the relative risk decreased to 20% compared to current smokers. The following characteristics were associated with a higher relative risk: inhalation of smoke, smoking non‐filter cigarettes, smoking dark‐type cigarettes and starting at young age. The association was observed for all major histological types, being the strongest for small‐cell type carcinoma, followed by squamous‐cell type and the lowest for adenocarcinoma. The proportion of lung‐cancer cases in the population attributable to cigarette smoking ranged from 14% to 85%. We concluded that women share most features of the association between cigarette smoking and lung cancer observed in men. Int. J. Cancer 88:820–827, 2000. © 2000 Wiley‐Liss, Inc.