Japanese Journal of Clinical Oncology Advance Access originally published online on May 30, 2006
Japanese Journal of Clinical Oncology 2006 36(5):309-324; doi:10.1093/jjco/hyl025
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© 2006 Foundation for Promotion of Cancer Research
Tobacco Smoking and Lung Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiological Evidence Among the Japanese Population
1 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 2 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, 3 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 4 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, 5 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, 6 Department of Epidemiology and Preventive Medicine, Gifu University School of Medicine, Gifu, Japan
For reprints and all correspondence: Kenji Wakai, Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. Tel: +81 052-764-2988; Fax: +81 052-763-5233; E-mail: wakai{at}aichi-cc.jp
Received December 19, 2005; accepted March 12, 2006
Background: Although tobacco smoking is the best established risk factor for lung cancer, the association is not as strong among Japanese as among Western populations. It would be of value, therefore, to quantify that association in Japan based on a systematic review of epidemiological evidence for the primary prevention of lung cancer.
Methods: Original data were obtained from MEDLINE searches using PubMed, supplemented with manual searches. The evaluation of associations was based on the strength of evidence and the magnitude of the association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer. A meta-analysis was also conducted to estimate the summary measure of those associations.
Results: A total of 8 cohort studies and 14 case–control studies were identified, almost all of which consistently showed a strong association of current smoking with the risk of lung cancer. The summary relative risk for current smokers versus never smokers was estimated as 4.39 (95% confidence interval 3.92–4.92) for men and 2.79 (95% confidence interval 2.44–3.20) for women. Cohort studies and case–control studies gave reasonably consistent summary measures. The summary relative risks were 11.7 and 2.30 for squamous cell carcinoma and adenocarcinoma, respectively, in men, and were 11.3 and 1.37 correspondingly in women.
Conclusion: There is convincing evidence that tobacco smoking strongly increases the risk of lung cancer in the Japanese population, with the relative risk for current smokers compared with never smokers measuring around 4.4 for men and 2.8 for women.
Key Words: systematic review • epidemiology • smoking • lung neoplasms • Japanese
* Research group members: Shoichiro Tsugane (principal investigator), Manami Inoue, Shizuka Sasazuki, Motoki Iwasaki, Tetsuya Otani, National Cancer Center, Tokyo; Kenji Wakai, Aichi Cancer Center, Nagoya; Tetsuya Mizoue, Kyushu University, Fukuoka; Keitaro Tanaka, Saga University, Saga; Ichiro Tsuji (2004–), Yoshitaka Tsubono (2003), Taichi Shimazu, Tohoku University, Sendai; and Chisato Nagata, Gifu University, Gifu.
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