中国男性戒烟最初5年内,肺癌发病率显著下降
2011/08/30
摘要
背景:在之前的研究中,对男性戒烟后肺癌发病风险的下降及其早期下降幅度的重要性,尚未进行详细阐述。在一项基于人群的病例参考研究中,对戒烟时间与主要组织类型的肺癌发病风险间的具体持续时间-反应相关性进行了评价。
方法:从2004年~2006年,在香港最大的肿瘤中心,连续收集1208名中国男性原发性肺癌患者,并选取社区中匹配的1069名男性作为对照,进行为期5年的研究。采用无条件的多元logistic回归分析和广义相加模型,将平滑样条整合后建立戒烟时间对肺癌非线性影响的模型。
结果:所有组织类型的肺癌均与当前吸烟状态呈显著相关。我们观察到,在戒烟后的最初5年内,所有组织类型(除大细胞类型外)肺癌的优势比快速下降(>50%),在随后数年内,肺癌发病率仍然持续下降,但趋缓。
结论:戒烟后的最初5年内的肺癌发病风险显著下降,对于慢性吸烟者、临床医生和公共卫生工作者来说,这是一个令人鼓舞的信息。
(陈欣 审校)
J Thorac Oncol. 2011 Jul 8. [Epub ahead of print]
Lung Cancer Decreased Sharply in First 5 Years After Smoking Cessation in Chinese Men.
Tse LA, Yu IT, Qiu H, Au JS, Wang XR, Tam W, Yu KS.
Source
*School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin; and †Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, HKSAR, China.
Abstract
BACKGROUND: The rate of decline in lung cancer risk after smoking cessation among male population and the importance of the magnitude of the early decline were not sufficiently defined in the earlier studies. We evaluated the detailed duration-response relationship between years since smoking cessation and lung cancer risk across major histological types in a population-based case-referent study.
METHODS: We recruited 1208 consecutive incident cases of primary lung cancer among Chinese males from the largest oncology center in Hong Kong during 2004-2006, and 1069 male community referents frequency-matched in 5-year age groups. We performed unconditional multiple logistic regression and generalized additive model incorporating smoothing spline to model the potential nonlinear effect of years since cessation on lung cancer.
RESULTS: All histological types of lung cancer were strongly associated with current smoking. We observed a rapidly decreasing odds ratio of lung cancer (>50%) across all major histological types of lung cancer (except for the large cell type) within the first 5 years of quitting; the odds ratio continued to decrease but at a slower rate in the subsequent years.
CONCLUSION: The substantial benefits obtainable within a short period of 5 years’ abstinence should convey an encouraging message to chronic smokers, clinicians, and public health workers.
J Thorac Oncol. 2011 Jul 8. [Epub ahead of print]