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Japanese Journal of Clinical Oncology Advance Access published online on June 9, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl031
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© 2006 Foundation for Promotion of Cancer Research
Received January 30, 2006
Accepted March 7, 2006

Original Article

Tobacco Smoking and Breast Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiological Evidence among the Japanese Population

Chisato Nagata 1 *, Tetsuya Mizoue 2, Keitaro Tanaka 3, Ichiro Tsuji 4, Kenji Wakai 5, Manami Inoue 6, Shoichiro Tsugane 6, and Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan

1 Department of Epidemiology & Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
2 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
3 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, Japan
4 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
5 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
6 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan

* To whom correspondence should be addressed.
Chisato Nagata, E-mail: chisato{at}cc.gifu-u.ac.jp


  Abstract

Background: Our research group undertook an appraisal of the body of epidemiological studies on cancer in Japan to evaluate the existing evidence concerning the association between health-related lifestyles and cancer. As tobacco smoking may be one of the few modifiable risk factors for breast cancer, we focused on the association between tobacco smoking and the risk of breast cancer in this review.

Methods: A MEDLINE search was conducted to identify epidemiological studies on the association between smoking and breast cancer incidence or mortality among the Japanese from 1966 to 2005. Evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as previously evaluated by the International Agency for Research on Cancer.

Results: Three cohort studies and eight case-control studies were identified. The relative risk (RR) or odds ratio (OR) of breast cancer for current smokers ranged from 0.71 to 6.26 in these studies. A significantly increased risk among current smokers compared with never smokers (RR = 1.7) was reported in one out of the three cohort studies. Moderate or strong associations between smoking and breast cancer risk (OR > 2.0) were observed in four of the eight case-control studies. Experimental studies have supported the biological plausibility of a positive association between tobacco smoking and breast cancer risk.

Conclusion: We conclude that tobacco smoking possibly increases the risk of breast cancer in the Japanese population.

Keywords: systematic review; epidemiology; tobacco smoking; breast cancer; the Japanese.
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