吸烟特征对泌尿道癌症风险的影响：一个流行病学研究的荟萃分析
2010/01/05
目的：这篇系统性回顾的目的是对不同吸烟特征的影响进行概括和量化（包括一般情况、吸烟量、吸烟持续时间、戒烟以及首次暴露的年龄）。
方法：作者共选取了43个流行病学研究（8个队列研究和35个病例-对照研究），通过不同吸烟特征的偏回归分析计算简略优势比(SORs)，并简要评价不同研究的方法学上的差别。
结果：吸烟状态和吸烟数量、吸烟时间的增加都与泌尿道癌症的风险增加有着强的相关关系。戒烟和首次暴露的年龄与泌尿道癌症的风险有着负相关关系。现在吸烟者及过去吸烟者的患病风险与非吸烟者相比，经年龄与性别调整后的简略优势比(SORs) 分别为3.33 (95% 可信区间[CI], 2.63-4.21) 和1.98 (CI, 1.72-2.29)。尽管这些研究在方法学上存在差别，但最终得到的结果是一致性的。
结论： 结果显示吸烟确实增加了泌尿系癌症的风险。基于这个研究和以往文献的结果，作者推论现在的吸烟者患泌尿系癌症的风险比不吸烟者高接近三倍。在欧洲的泌尿系癌症病例中，接近一般的男性患者和三分之一的女性患者发病可能与吸烟有关。
（张永明编译 刘国梁审校）
Cancer. 2000 Aug 1;89(3):630-639
The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies.
Maastricht University, Department of Epidemiology, Maastricht, The Netherlands.
BACKGROUND: Although narrative reviews have concluded that there is strong support for an association between cigarette smoking and urinary tract cancer, the association has never been quantified systematically in reviews. The purpose of this systematic review was to summarize and quantify the impact of different smoking characteristics (status, amount, duration, cessation, and age at first exposure) both unadjusted and adjusted for age and gender.
METHODS: The authors included 43 epidemiologic studies (8 cohort and 35 case-control) and calculated summary odds ratios (SORs) by meta-regression analyses for different smoking characteristics. They also evaluated changes in summary estimates according to differences in study methodology.
RESULTS: Smoking status and increased amount and duration of smoking were associated with a strong increased risk of urinary tract cancer. Smoking cessation and age at first exposure were negatively associated with the risk of urinary tract cancer. The age- and gender-adjusted SORs for current and former cigarette smokers compared with those for nonsmokers were 3.33 (95% confidence interval [CI], 2.63-4.21) and 1.98 (CI, 1.72-2.29), respectively. Even though the component studies differed in methodology, the results were rather consistent.
METHODS: The authors included 43 epidemiologic studies (8 cohort and 35 case-control) and calculated summary odds ratios (SORs) by meta-regression analyses for different smoking characteristics. They also evaluated changes in summary estimates according to differences in study methodology.
RESULTS: Smoking status and increased amount and duration of smoking were associated with a strong increased risk of urinary tract cancer. Smoking cessation and age at first exposure were negatively associated with the risk of urinary tract cancer. The age- and gender-adjusted SORs for current and former cigarette smokers compared with those for nonsmokers were 3.33 (95% confidence interval [CI], 2.63-4.21) and 1.98 (CI, 1.72-2.29), respectively. Even though the component studies differed in methodology, the results were rather consistent.
CONCLUSIONS: The results suggest a substantial increase in risk of cancer of the urinary tract for cigarette smokers. Based on the results of this study and previous literature, the authors conclude that current cigarette smokers have an approximately threefold higher risk of urinary tract cancer than nonsmokers. In Europe, approximately half of urinary tract cancer cases among males and one-third of cases among females might be attributable to cigarette smoking. Copyright 2000 American Cancer Society.
PMID: 10931463 [PubMed - indexed for MEDLINE]
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