Gesundheitswesen 2010; 72 - P181
DOI: 10.1055/s-0030-1266688

Cigarette smoking and lung cancer – Risk estimates for the major histological types from a pooled analysis of European case-control studies

B Kendzia 1, P Gustavsson 2, H Pohlabeln 3, W Ahrens 3, K Jöckel 4, A Olsson 5, I Gross 6, I Brüske 7, H Wichmann 7, F Merletti 8, D Mirabelli 8, P Boffetta 9, K Straif 10, T Brüning 11 B Pesch 11 for the Synergy Study Group colleagues
  • 1Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität-Bochum (IPA), Bochum
  • 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm
  • 3Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Bremen
  • 4Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen
  • 5International Agency for Research on Cancer (IARC), Lyon
  • 6Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität-Bochum (IPA), Bochum
  • 7Helmholtz Zentrum München, Institute of epidemiology, German Research Center for Environmental Health, Munich
  • 8Cancer Epidemiology Unit, CPO-Piemonte and University of Turin, Turin
  • 9The Tisch Cancer Institute, Mount Sinai School of Medicine, New York
  • 10Cancer Epidemiology Unit, CPO-Piemonte and 5 International Agency for Research on Cancer (IARC), Lyon
  • 11Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität-Bochum (IPA), Bochum

Introduction: Smoking is a strong risk factor for lung cancer. As part of a series of supplemental analyses of the project SYNERGY that has been designed as a pooled analysis of lung cancer studies on the interaction of occupational carcinogens the risk of smoking was estimated for histological subtypes. Materials and Methods: This dataset comprised 10,050 cases (8,403 males, 1,647 females) and 12,388 controls (10,246 males, 2,142 females) from 11 European countries. Odds ratios (ORs) and 95% confidence intervals (CIs) of smoking cigarettes for squamous cell carcinoma (SqCC), small cell lung carcinoma (SCLC), and adenocarcinoma (AdCa) were estimated with logistic regression models in men and women, conditional on study center, adjusted for smoking of any other type of tobacco (yes/no) and age (in five-year classes). Results: Only 2% males and 29% females were never smokers, with AdCa as leading subtype. In current smokers, 54% men and 35% women had a diagnosis of SqCC. Current smoking of cigarettes was associated with an OR of 45.3 (95% CI 33.3–61.6) for SqCC, 43.0 (95% CI 27.5–67.3) for SCLC, and 9.2 (95% CI 7.2–11.7) for AdCa among men. The corresponding risk estimates in women were 12.4 (95% CI 9.2–16.5) for SqCC, 17.7 (95% CI 12.4–25.3) for SCLC, and 3.2 (95% CI 2.5–4.0) for AdCa. High risks of current smoking of >30 cigarettes/day were observed for SqCC (OR 91.6; 95% CI 64.2–130.6) and SCLC (OR 84.5; 95% CI 51.2–139.6) in men and for SqCC (OR 46.9; 95% CI 17.3–127.1) and SCLC (OR 77.4; 95% CI 22.7–263.8) in women. Conclusion: Cigarette smoking in our study was associated with a considerably higher risk both for SqCC and SCLC than for AdCa. These observations corroborate findings from experimental and former epidemiological studies.