Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis

Published by BMJ. Objectives To investigate the sex-specific association between smoking and lung cancer. Design Systematic review and meta-analysis. Data sources We searched PubMed and EMBASE from 1 January 1999 to 15 April 2016 for cohort studies. Cohort studies before 1 January 1999 were retrieve...

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Main Authors: O'Keeffe, L., Taylor, G., Huxley, Rachel, Mitchell, P., Woodward, M., Peters, S.
Format: Journal Article
Published: BM J Group 2018
Online Access:http://hdl.handle.net/20.500.11937/71289
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author O'Keeffe, L.
Taylor, G.
Huxley, Rachel
Mitchell, P.
Woodward, M.
Peters, S.
author_facet O'Keeffe, L.
Taylor, G.
Huxley, Rachel
Mitchell, P.
Woodward, M.
Peters, S.
author_sort O'Keeffe, L.
building Curtin Institutional Repository
collection Online Access
description Published by BMJ. Objectives To investigate the sex-specific association between smoking and lung cancer. Design Systematic review and meta-analysis. Data sources 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. Eligibility criteria for selecting studies Cohort studies reporting the sex-specific relative risk (RR) of lung cancer associated with smoking. Results 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; I 2 =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. Conclusions 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.
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spelling curtin-20.500.11937-712892019-01-15T05:33:36Z Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis O'Keeffe, L. Taylor, G. Huxley, Rachel Mitchell, P. Woodward, M. Peters, S. Published by BMJ. Objectives To investigate the sex-specific association between smoking and lung cancer. Design Systematic review and meta-analysis. Data sources 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. Eligibility criteria for selecting studies Cohort studies reporting the sex-specific relative risk (RR) of lung cancer associated with smoking. Results 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; I 2 =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. Conclusions 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. 2018 Journal Article http://hdl.handle.net/20.500.11937/71289 10.1136/bmjopen-2018-021611 http://creativecommons.org/licenses/by/4.0/ BM J Group fulltext
spellingShingle O'Keeffe, L.
Taylor, G.
Huxley, Rachel
Mitchell, P.
Woodward, M.
Peters, S.
Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title_full Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title_fullStr Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title_full_unstemmed Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title_short Smoking as a risk factor for lung cancer in women and men: A systematic review and meta-analysis
title_sort smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis
url http://hdl.handle.net/20.500.11937/71289