American Journal of Epidemiology Advance Access originally published online on January 6, 2009
American Journal of Epidemiology 2009 169(5):533-541; doi:10.1093/aje/kwn385
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ORIGINAL CONTRIBUTIONS |
Environmental Tobacco Smoke and Lung Cancer Among Chinese Nonsmoking Males: Might Adenocarcinoma Be the Culprit?
Correspondence to Ignatius Tak-Sun Yu, Department of Community and Family Medicine, School of Public Health, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China (e-mail: iyu{at}cuhk.edu.hk).
Received for publication August 13, 2008. Accepted for publication November 7, 2008.
No studies have specifically reported the association of lung adenocarcinoma with environmental tobacco smoke (ETS) exposure among nonsmoking males. The objective of this study was to examine the exposure-response relation between ETS exposure and lung cancer among nonsmoking males. In particular, the association with adenocarcinoma of the lung was studied. This is a population-based, case-referent study in Hong Kong during 2004–2006. A total of 132 Chinese male nonsmokers with newly diagnosed primary lung cancer and 536 nonsmoking community referents were interviewed about ETS exposures from the household and/or workplace, including ever ETS exposure, sources of exposure, number of smoking cohabitants/coworkers, and smoker-years. Univariate logistic regression analyses showed a weak association between all lung cancers and ever ETS exposure from the household and/or workplace (odds ratio (OR) = 1.11, 95% confidence interval (CI): 0.74, 1.67), but an increased risk was restricted to adenocarcinoma (OR = 1.68, 95% CI: 1.00, 2.38). After adjustment for family cancer history and other confounders, excess risk (OR = 1.62, 95% CI: 0.91, 2.88) still persisted for adenocarcinoma, although it was no longer statistically significant. Exposure-response relations for adenocarcinoma were found with increasing levels of all ETS indices when exposures from the household and workplaces were combined. The consistent exposure-response relations between ETS exposures and adenocarcinoma suggested a probable causal link, which would have to be confirmed by future larger studies.
adenocarcinoma; lung neoplasms; tobacco smoke pollution
Abbreviations: CI, confidence interval; ETS, environmental tobacco smoke; IARC, International Agency for Research on Cancer; OR, odds ratio