In a prospective cohort of 41,836 Iowa women aged 55-69 years with 13 years of follow-up from 1986 through 1998, the authors examined the association between cigarette smoking history and three common histologic subtypes of lung cancer (123 small cell, 115 squamous cell, and 234 adenocarcinoma). Using Cox proportional hazards and additive Poisson regression analysis, they estimated four epidemiologic measures of effect: age-adjusted incidence rate, relative risk, excess risk (or risk difference), and population attributable risk. Of the three major lung cancer subtypes, the excess risk for heavy smokers compared with never smokers was higher for adenocarcinoma (excess risk = 206) than for squamous cell (excess risk = 122) and small cell (excess risk = 104) carcinomas. Adenocarcinoma of the lung is more strongly associated with tobacco smoke exposure than previously recognized.
Bibliographical noteFunding Information:
This work was supported by National Cancer Institute grant R01CA39741. Dr. Cerhan was supported in part by grant K0764220. Dr. Yang has been partially supported by grant R01 CA80127 from the National Institutes of Health.
- Lung neoplasms
- Neoplasms by histologic type
- Relative risk
- Risk assessment