American Journal of Epidemiology Vol. 138, No. 5: 281-293
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Are Female Smokers at Higher Risk for Lung Cancer than Male Smokers?
A Case-Control Analysis by Histologic Type
1Department of Epidemiology and Public Health, Yale University School of Medicine New Haven, CT
2NCIC Epidemiology Unit, Department of Preventive Medicine and Biostatistics, University of Toronto Toronto, Ontario, Canada
3Division of Epidemiology and Statistics, Ontario Cancer Treatment and Research Foundation Toronto, Ontario, Canada
4Department of Preventive Medicine and Biostatistics, University of Toronto Toronto, Ontario, Canada
Reprint requests to Dr. Harvey A. Risch, Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, P.O. Box 3333, New Haven, CT 06510
A case-control study of male-female differences in cigarette smoking and lung cancer was conducted during 1981–1985 in Toronto, St. Catharine's, and Niagara Falls, Ontario, Canada. In total, 442 female and 403 male histologically verified cancer cases were individually matched by age and area of residence to each other and to 410 female and 362 male randomly selected population controls. Subjects were interviewed concerning their exposures to various life-style factors, and in particular, they received detailed questioning regarding their lifelong histories of usage of tobacco products. It was found that, for both sexes, a greatly elevated risk of developing lung cancer was associated with cigarette consumption, increasing with pack-years of cigarettes smoked and declining with duration of time since quitting smoking. Furthermore, the association was significantly (p = 0.010) and appreciably stronger for females than for males. At a history of 40 pack-years relative to lifelong nonsmoking, the odds ratio for women was 27.9 (95% confidence interval (Cl) 14.9–52.0) and that for men was 9.60 (95% Cl 5.64– 16.3). Higher odds ratios for females were also seen within each of the major histologic groupings. Thus, the higher elevated risk of lung cancer currently observed in other studies for female ever smokers compared with male ever smokers, while possibly attributable in part to greater smoking cessation among males, may be due to higher susceptibility among females. Am J Epidemiol 1993; 138:281–93.
histology; lung neoplasms; men; retrospective studies; sex factors; smoking; women
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