|Emerging tobacco-related cancer risks in China: A nationwide, prospective study of 0.5 million adults|
|Chen, Zheng-Ming1,2; Peto, Richard1,2; Iona, Andri1,2; Guo, Yu3; Chen, Yi-Ping1,2; Bian, Zheng3; Yang, Ling1,2; Zhang, Wei-Yuan4; Lu, Feng5; Chen, Jun-Shi6; Collins, Rory1,2; Li, Li-Ming3,7|
|关键词||Cancer Cessation China Cohort Study Smoking|
|WOS标题词||Science & Technology|
|关键词[WOS]||United-states ; Cigarette-smoking ; Mortality ; Hazards ; Health ; Prevalence ; Epidemic ; Deaths|
BACKGROUNDIn China, cigarette consumption has increased substantially since the 1980s, almost exclusively in men. This study was aimed at assessing the emerging cancer risks.
METHODSA nationwide, prospective study recruited 210,259 men and 302,632 women aged 30 to 79 years from 10 areas of China from 2004 to 2008; approximately 18,000 incident cancers were recorded during 7 years of follow-up. Cox regression yielded adjusted risk ratios (RRs) comparing smokers (including those who had stopped because of illness but not those who had stopped by choice) with never-smokers.
RESULTSAmong men, 68% were smokers; their overall cancer risk was significantly increased (RR, 1.44; 95% confidence interval [CI], 1.37-1.53), and it was greater in urban (RR, 1.55; 95% CI, 1.41-1.70) than in rural areas (RR, 1.39; 95% CI, 1.30-1.49). This excess accounted for 23% of all cancers between the ages of 40 and 79 years, with significantly elevated risks of lung cancer (RR, 2.51; 95% CI, 2.18-2.90), liver cancer (RR, 1.32; 95% CI, 1.12-1.54), stomach cancer (RR, 1.34; 95% CI, 1.16-1.55), esophageal cancer (RR, 1.47; 95% CI, 1.24-1.73), and an aggregate of 5 other minor sites (RR, 1.52; 95% CI, 1.25-1.86). For lung cancer, the RRs were much greater for nonadenocarcinoma (RR, 5.83; 95% CI, 5.02-6.77) than for adenocarcinoma (RR, 1.78; 95% CI, 1.36-2.34). Among exsmokers (6.7%) who had stopped by choice, there was little excess cancer risk approximately 15 years after quitting. Among the few female smokers (3%), the overall cancer risk was also significantly increased (RR, 1.42; 95% CI, 1.28-1.57). Smoking was estimated to cause approximately 435,000 new cancers per year in China (approximately 360,000 in men and approximately 75,000 in women).
CONCLUSIONSIn China, smoking now causes a quarter of all adult male cancers. High male uptake rates before the age of 20 years and nearly universal use of cigarettes foreshadow substantial tobacco-attributed risks in China unless there is widespread cessation. Cancer 2015;121:3097-106. (c) 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
|资助机构||Kadoorie Foundation ; Wellcome Trust ; UK Medical Research Council ; British Heart Foundation ; Cancer Research UK ; National Natural Science Foundation of China|
|作者单位||1.Univ Oxford, Clin Trial Serv Unit, Oxford OX3 7LF, England|
2.Univ Oxford, Epidemiol Studies Unit, Nuffield Dept Populat Hlth, Oxford OX3 7LF, England
3.Chinese Acad Med Sci, Beijing 100730, Peoples R China
4.Liuzhou Ctr Dis Control & Prevent, Liuzhou, Peoples R China
5.Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Zhejiang, Peoples R China
6.China Natl Ctr Food Safety Risk Assessment, Beijing, Peoples R China
7.Peking Univ, Dept Epidemiol & Biostat, Sch Publ Hlth, Beijing 100191, Peoples R China
|Chen, Zheng-Ming,Peto, Richard,Iona, Andri,et al. Emerging tobacco-related cancer risks in China: A nationwide, prospective study of 0.5 million adults[J]. CANCER,2015,suppl.17(SI):3097-3106.|
|APA||Chen, Zheng-Ming.,Peto, Richard.,Iona, Andri.,Guo, Yu.,Chen, Yi-Ping.,...&Li, Li-Ming.(2015).Emerging tobacco-related cancer risks in China: A nationwide, prospective study of 0.5 million adults.CANCER,suppl.17(SI),3097-3106.|
|MLA||Chen, Zheng-Ming,et al."Emerging tobacco-related cancer risks in China: A nationwide, prospective study of 0.5 million adults".CANCER suppl.17.SI(2015):3097-3106.|