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Article: Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men

TitleSmoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men
Authors
KeywordsNasopharyngeal carcinoma
smoking
epidemiology
cohort study
individual data
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://ije.oxfordjournals.org/
Citation
International Journal of Epidemiology, 2021, v. 50 n. 3, p. 975-986 How to Cite?
AbstractBackground: The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC. Methods: We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status. Results: During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26). Conclusions: This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12–16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.
DescriptionHybrid open access
Persistent Identifierhttp://hdl.handle.net/10722/301724
ISSN
2023 Impact Factor: 6.4
2023 SCImago Journal Rankings: 2.663
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLin, J-
dc.contributor.authorWen, CP-
dc.contributor.authorJiang, CQ-
dc.contributor.authorYuan, JM-
dc.contributor.authorChen, CJ-
dc.contributor.authorHo, SY-
dc.contributor.authorGao, W-
dc.contributor.authorZhang, W-
dc.contributor.authorWang, RW-
dc.contributor.authorChien, YC-
dc.contributor.authorXu, L-
dc.contributor.authorWu, X-
dc.contributor.authorJin, YL-
dc.contributor.authorKoh, WP-
dc.contributor.authorHsu, WL-
dc.contributor.authorZhu, F-
dc.contributor.authorWen, C-
dc.contributor.authorZhu, T-
dc.contributor.authorLee, JH-
dc.contributor.authorMai, ZM-
dc.contributor.authorLung, ML-
dc.contributor.authorLam, TH-
dc.date.accessioned2021-08-09T03:43:18Z-
dc.date.available2021-08-09T03:43:18Z-
dc.date.issued2021-
dc.identifier.citationInternational Journal of Epidemiology, 2021, v. 50 n. 3, p. 975-986-
dc.identifier.issn0300-5771-
dc.identifier.urihttp://hdl.handle.net/10722/301724-
dc.descriptionHybrid open access-
dc.description.abstractBackground: The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC. Methods: We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status. Results: During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26). Conclusions: This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12–16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ije.oxfordjournals.org/-
dc.relation.ispartofInternational Journal of Epidemiology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectNasopharyngeal carcinoma-
dc.subjectsmoking-
dc.subjectepidemiology-
dc.subjectcohort study-
dc.subjectindividual data-
dc.titleSmoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men-
dc.typeArticle-
dc.identifier.emailJiang, CQ: cqjiang@hkucc.hku.hk-
dc.identifier.emailHo, SY: syho@hku.hk-
dc.identifier.emailZhang, W: zhangws9@hku.hk-
dc.identifier.emailXu, L: linxu@hku.hk-
dc.identifier.emailLung, ML: mlilung@hku.hk-
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hk-
dc.identifier.authorityHo, SY=rp00427-
dc.identifier.authorityXu, L=rp02030-
dc.identifier.authorityLung, ML=rp00300-
dc.identifier.authorityLam, TH=rp00326-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1093/ije/dyab060-
dc.identifier.pmid33787881-
dc.identifier.pmcidPMC8271191-
dc.identifier.scopuseid_2-s2.0-85112124727-
dc.identifier.hkuros324060-
dc.identifier.volume50-
dc.identifier.issue3-
dc.identifier.spage975-
dc.identifier.epage986-
dc.identifier.isiWOS:000685312900033-
dc.publisher.placeUnited Kingdom-

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