Lung cancer and cigarette smoking in Europe: An update of risk estimates and an assessment of inter-country heterogeneity
Corresponding Author
Lorenzo Simonato
Venetian Tumour Registry, University of Padua, Padua, Italy
ELCWP, Brussels, Belgium
Fax: +39-49-8076789
Universita degli Studi di Padova, Dipartimento di Schienze Oncologiche E Chirurgiche, via Gattamelata 64, Padova 35128, ItalySearch for more papers by this authorAntonio Agudo
Department of Epidemiology and Cancer Registration, Barcelona, Spain
Search for more papers by this authorWolfgang Ahrens
Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany
Search for more papers by this authorEllen Benhamou
National Institute of Health and Medical Research, INSERM, Villejuif, France
Search for more papers by this authorSimone Benhamou
National Institute of Health and Medical Research, INSERM, Villejuif, France
Search for more papers by this authorPaolo Boffetta
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorPaul Brennan
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorSarah C. Darby
Imperial Cancer Research Fund, Oxford, United Kingdom
Search for more papers by this authorFrancesco Forastiere
Epidemiology Unit Latium Region, Rome, Italy
Search for more papers by this authorValérie Gaborieau
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorMichael Gerken
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorCarlos A. Gonzales
Department of Epidemiology and Cancer Registration, Barcelona, Spain
Search for more papers by this authorKarl-Heinz Jöckel
Institute for Medical Informatics, Biometry and Epidemiology, Essen, Germany
Search for more papers by this authorMichaela Kreuzer
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorFranco Merletti
Unit of Cancer Epidemiology and Centre for Oncological Prevention, University of Turin, Turin, Italy
Search for more papers by this authorFredrik Nyberg
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorGöran Pershagen
Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorHermann Pohlabeln
Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany
Search for more papers by this authorElise Whitley
Imperial Cancer Research Fund, Oxford, United Kingdom
Search for more papers by this authorHeinz-Erich Wichmann
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorCorresponding Author
Lorenzo Simonato
Venetian Tumour Registry, University of Padua, Padua, Italy
ELCWP, Brussels, Belgium
Fax: +39-49-8076789
Universita degli Studi di Padova, Dipartimento di Schienze Oncologiche E Chirurgiche, via Gattamelata 64, Padova 35128, ItalySearch for more papers by this authorAntonio Agudo
Department of Epidemiology and Cancer Registration, Barcelona, Spain
Search for more papers by this authorWolfgang Ahrens
Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany
Search for more papers by this authorEllen Benhamou
National Institute of Health and Medical Research, INSERM, Villejuif, France
Search for more papers by this authorSimone Benhamou
National Institute of Health and Medical Research, INSERM, Villejuif, France
Search for more papers by this authorPaolo Boffetta
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorPaul Brennan
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorSarah C. Darby
Imperial Cancer Research Fund, Oxford, United Kingdom
Search for more papers by this authorFrancesco Forastiere
Epidemiology Unit Latium Region, Rome, Italy
Search for more papers by this authorValérie Gaborieau
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorMichael Gerken
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorCarlos A. Gonzales
Department of Epidemiology and Cancer Registration, Barcelona, Spain
Search for more papers by this authorKarl-Heinz Jöckel
Institute for Medical Informatics, Biometry and Epidemiology, Essen, Germany
Search for more papers by this authorMichaela Kreuzer
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorFranco Merletti
Unit of Cancer Epidemiology and Centre for Oncological Prevention, University of Turin, Turin, Italy
Search for more papers by this authorFredrik Nyberg
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France
Search for more papers by this authorGöran Pershagen
Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Search for more papers by this authorHermann Pohlabeln
Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany
Search for more papers by this authorElise Whitley
Imperial Cancer Research Fund, Oxford, United Kingdom
Search for more papers by this authorHeinz-Erich Wichmann
GSF Institute of Epidemiology, Neuherberg, Germany
Search for more papers by this authorAbstract
Ten case-control studies have been carried out in 6 European countries to investigate the major risk factors for lung cancer. Carcinogenic effect from cigarette smoke was the most relevant interest in our study, which has included 7,609 cases of lung cancer and 10,431 controls, mainly population based. The results indicate elevated odds ratios (ORs; 23.9 among men and 8.7 among women) with attributable risks exceeding 90% for men and close to 60% for women. A large, and statistically significant, variability of the results across countries was detected after adjusting for the most common confounding variables, and after controlling, at least in part, for the instability of the ORs due to the small number of non-smokers in some of the study subsets. This pattern of lung cancer risk associated with cigarettes smoke, across different European regions, reflects inherent characteristics of the studies as well as differences in smoking habits, particularly calender periods of starting, and it is likely to have been influenced by effect modifiers like indoor radon exposure, occupation, air pollution and dietary habits. © 2001 Wiley-Liss, Inc.
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