TY - JOUR
T1 - Effects of active, passive, and combined smoking on cervical cancer mortality
T2 - a nationwide proportional mortality study in Chinese urban women
AU - Jiang, Jingmei
AU - Pang, Haiyu
AU - Liu, Boqi
AU - Nasca, Philip C.
AU - Zhang, Biao
AU - Wu, Yanping
AU - Han, Wei
AU - Gates, Margaret
AU - Lu, Tao
AU - Zou, Xiaonong
AU - Xue, Fang
AU - Hou, Lei
AU - Wang, Zixing
AU - Wang, Yuyan
AU - Chen, Yuanli
AU - Li, Junyao
N1 - Funding Information:
We thank Cancer Research UK, the UK Medical Research Council, the US National Institutes of Health, the Chinese Ministry of Health for supporting the original survey. We thank Professor Richard Peto, who gave us great support for the project. The thousands of doctors, nurses, and other field workers who conducted the surveys, the local governments for their cooperation, and the million interviewees are greatly acknowledged.
Publisher Copyright:
© 2015, Springer International Publishing Switzerland.
PY - 2015/7/13
Y1 - 2015/7/13
N2 - Purpose: To determine whether smoking, in any form, is a risk factor in the development of cervical cancer (CC) among urban Chinese women. Methods: We ascertained retrospectively the smoking habits of 1,865 women (aged 35+) who had died from CC (cases) and 48,781 who had died from causes unrelated to smoking (controls) in 24 cities using data from a large national survey of smoking and mortality in 1989–1991. We assessed the risk of smoking on CC mortality with and without considering passive smoke exposure from a spouse using a proportional mortality study design. Results: Overall, there was a 51.0 % excess risk of death from CC among smokers. When the spouse’s exposure was further considered, the RR (95 % CI) for exposed versus unexposed women was 1.28 (1.04–1.57) for passive smokers, 1.49 (1.02–2.20) for active smokers, and 1.69 (1.27–2.26) for women with both exposures (all p < 0.001). Significant dose–response associations were observed between smoking and CC for all categories of exposure. For example, individuals with both smoking exposure had the highest risk of CC mortality with moderate [RR = 1.67 (1.18–2.38)] and high [RR = 1.88 (1.04–3.41)] daily cigarette consumption, and they also had the highest risk with ≤15 years exposure [RR = 1.73 (1.19–2.52)] and >15 years exposure [RR = 1.95 (1.15–3.32)], compared with the active and passive groups (p for trend <0.001). Conclusions: Younger trend of CC death and the rapid increase in smoking among young women may have a profound impact on future incidence of CC. Our findings emphasize the need for preventive efforts among both women and men in China.
AB - Purpose: To determine whether smoking, in any form, is a risk factor in the development of cervical cancer (CC) among urban Chinese women. Methods: We ascertained retrospectively the smoking habits of 1,865 women (aged 35+) who had died from CC (cases) and 48,781 who had died from causes unrelated to smoking (controls) in 24 cities using data from a large national survey of smoking and mortality in 1989–1991. We assessed the risk of smoking on CC mortality with and without considering passive smoke exposure from a spouse using a proportional mortality study design. Results: Overall, there was a 51.0 % excess risk of death from CC among smokers. When the spouse’s exposure was further considered, the RR (95 % CI) for exposed versus unexposed women was 1.28 (1.04–1.57) for passive smokers, 1.49 (1.02–2.20) for active smokers, and 1.69 (1.27–2.26) for women with both exposures (all p < 0.001). Significant dose–response associations were observed between smoking and CC for all categories of exposure. For example, individuals with both smoking exposure had the highest risk of CC mortality with moderate [RR = 1.67 (1.18–2.38)] and high [RR = 1.88 (1.04–3.41)] daily cigarette consumption, and they also had the highest risk with ≤15 years exposure [RR = 1.73 (1.19–2.52)] and >15 years exposure [RR = 1.95 (1.15–3.32)], compared with the active and passive groups (p for trend <0.001). Conclusions: Younger trend of CC death and the rapid increase in smoking among young women may have a profound impact on future incidence of CC. Our findings emphasize the need for preventive efforts among both women and men in China.
KW - Cervical cancer
KW - Chinese women
KW - Mortality
KW - Passive smoking
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=84930928824&partnerID=8YFLogxK
U2 - 10.1007/s10552-015-0580-x
DO - 10.1007/s10552-015-0580-x
M3 - Article
C2 - 25898822
AN - SCOPUS:84930928824
VL - 26
SP - 983
EP - 991
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 7
ER -