Publication:
Ovarian cancer and smoking: Individual participant meta-analysis including 28 114 women with ovarian cancer from 51 epidemiological studies

Issued Date

2012-01-01

Resource Type

Article

ISSN

14745488
14702045

DOI

10.1016/S1470-2045(12)70322-4

Other identifier(s)

2-s2.0-84877875955

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

The Lancet Oncology. Vol.13, No.9 (2012), 946-956

Suggested Citation

E. E. Calle, S. M. Gapstur, A. V. Patel, L. Dal Maso, R. Talamini, A. Chetrit, G. Hirsh-Yechezkel, F. Lubin, S. Sadetzki, E. Banks, V. Beral, D. Bull, K. Callaghan, B. Crossley, K. Gaitskell, A. Goodill, J. Green, C. Hermon, T. Key, K. Moser, G. Reeves, F. Sitas, R. Collins, R. Doll, R. Peto, C. A. Gonzalez, N. Lee, P. Marchbanks, H. W. Ory, H. B. Peterson, P. A. Wingo, N. Martin, T. Pardthaisong, S. Silpisornkosol, C. Theetranont, B. Boosiri, S. Chutivongse, P. Jimakorn, P. Virutamasen, C. Wongsrichanalai, A. Tjonneland, L. Titus-Ernstoff, T. Byers, T. Rohan, B. J. Mosgaard, M. Vessey, D. Yeates, J. L. Freudenheim, J. Chang-Claude, R. Kaaks, K. E. Anderson, A. Folsom, K. Robien, J. Hampton, P. A. Newcomb, M. A. Rossing, D. B. Thomas, N. S. Weiss, E. Riboli, F. Clavel-Chapelon, D. Cramer, S. E. Hankinson, S. S. Tworoger, S. Franceschi, C. La Vecchia, E. Negri, H. O. Adami, C. Magnusson, T. Riman, E. Weiderpass, A. Wolk, L. J. Schouten, P. A. van den Brandt, N. Chantarakul, S. Koetsawang, D. Rachawat, D. Palli, A. Black, L. A. Brinton, D. M. Freedman, P. Hartge, A. W. Hsing, Jr V. Lacey, R. N. Hoover, C. Schairer, M. Urban, S. Graff-Iversen, R. Selmer, C. J. Bain, A. C. Green, D. M. Purdie, V. Siskind, P. M. Webb, K. Moysich, S. E. McCann, P. Hannaford, C. Kay, C. W. Binns, A. H. Lee, M. Zhang Ovarian cancer and smoking: Individual participant meta-analysis including 28 114 women with ovarian cancer from 51 epidemiological studies. The Lancet Oncology. Vol.13, No.9 (2012), 946-956. doi:10.1016/S1470-2045(12)70322-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/15124

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Thesis

Title

Ovarian cancer and smoking: Individual participant meta-analysis including 28 114 women with ovarian cancer from 51 epidemiological studies

Author(s)

E. E. Calle
 S. M. Gapstur
 A. V. Patel
 L. Dal Maso
 R. Talamini
 A. Chetrit
 G. Hirsh-Yechezkel
 F. Lubin
 S. Sadetzki
 E. Banks
 V. Beral
 D. Bull
 K. Callaghan
 B. Crossley
 K. Gaitskell
 A. Goodill
 J. Green
 C. Hermon
 T. Key
 K. Moser
 G. Reeves
 F. Sitas
 R. Collins
 R. Doll
 R. Peto
 C. A. Gonzalez
 N. Lee
 P. Marchbanks
 H. W. Ory
 H. B. Peterson
 P. A. Wingo
 N. Martin
 T. Pardthaisong
 S. Silpisornkosol
 C. Theetranont
 B. Boosiri
 S. Chutivongse
 P. Jimakorn
 P. Virutamasen
 C. Wongsrichanalai
 A. Tjonneland
 L. Titus-Ernstoff
 T. Byers
 T. Rohan
 B. J. Mosgaard
 M. Vessey
 D. Yeates
 J. L. Freudenheim
 J. Chang-Claude
 R. Kaaks
 K. E. Anderson
 A. Folsom
 K. Robien
 J. Hampton
 P. A. Newcomb
 M. A. Rossing
 D. B. Thomas
 N. S. Weiss
 E. Riboli
 F. Clavel-Chapelon
 D. Cramer
 S. E. Hankinson
 S. S. Tworoger
 S. Franceschi
 C. La Vecchia
 E. Negri
 H. O. Adami
 C. Magnusson
 T. Riman
 E. Weiderpass
 A. Wolk
 L. J. Schouten
 P. A. van den Brandt
 N. Chantarakul
 S. Koetsawang
 D. Rachawat
 D. Palli
 A. Black
 L. A. Brinton
 D. M. Freedman
 P. Hartge
 A. W. Hsing
 Jr V. Lacey
 R. N. Hoover
 C. Schairer
 M. Urban
 S. Graff-Iversen
 R. Selmer
 C. J. Bain
 A. C. Green
 D. M. Purdie
 V. Siskind
 P. M. Webb
 K. Moysich
 S. E. McCann
 P. Hannaford
 C. Kay
 C. W. Binns
 A. H. Lee
 M. Zhang

Other Contributor(s)

American Cancer Society
 IRCCS Centro Di Riferimento Oncologico Aviano
 The Gertner Institute
 The National Israeli Study on Ovarian Cancer (NISOC) group
 Cancer Council New South Wales
 Cancer Research UK
 Institute Catala Oncologia
 Centers for Disease Control and Prevention
 Chiang Mai University
 Chulalongkorn University
 Institute of Cancer Epidemiology - Denmark
 Geisel School of Medicine at Dartmouth
 Colorado School of Public Health
 Albert Einstein College of Medicine of Yeshiva University
 Amtssygehuset i Herlev
 Department of Public Health
 University at Buffalo, State University of New York
 German Cancer Research Center
 University of Minnesota School of Public Health
 University of Washington, Seattle
 Imperial College London
 Centre de recherche en epidemiologie et sante des populations
 Harvard Medical School
 International Agency for Research on Cancer
 Universita degli Studi di Milano
 Karolinska Institutet
 Maastricht University
 Mahidol University
 Centro Per Lo Studio E La Prevenzione Oncologica
 National Cancer Institute
 National Health Laboratory Services
 Norwegian Institute of Public Health
 Queensland Institute of Medical Research
 Roswell Park Cancer Institute
 Royal College of General Practitioners' Oral Contraception Study
 Curtin University
 University of Texas School of Public Health
 University of Massachusetts Boston
 Boston University - Slone Epidemiology Unit
 Stanford University
 University of Athens Medical School
 Universidad de Chile
 University of Hawaii at Manoa
 Skånes universitetssjukhus
 University of Pennsylvania
 University of Pittsburgh
 University Medical Center Utrecht
 University of Southern California
 University of Toronto
 Universitetet i Tromso
 George Washington University
 Vanderbilt University
 Organisation Mondiale de la Sante
 Yale University

Abstract

Background Smoking has been linked to mucinous ovarian cancer, but its eff ects on other ovarian cancer subtypes and on overall ovarian cancer risk are unclear, and the fi ndings from most studies with relevant data are unpublished. To assess these associations, we review the published and unpublished evidence. Methods Eligible epidemiological studies were identifi ed by electronic searches, review articles, and discussions with colleagues. Individual participant data for 28 114 women with and 94 942 without ovarian cancer from 51 epidemiological studies were analysed centrally, yielding adjusted relative risks (RRs) of ovarian cancer in smokers compared with never smokers. Findings After exclusion of studies with hospital controls, in which smoking could have aff ected recruitment, overall ovarian cancer incidence was only slightly increased in current smokers compared with women who had never smoked (RR 1.06, 95% CI 1.01-1.11, p=0.01). Of 17 641 epithelial cancers with specifi ed histology, 2314 (13%) were mucinous, 2360 (13%) endo metrioid, 969 (5%) clear-cell, and 9086 (52%) serous. Smoking-related risks varied substantially across these subtypes (p heterogeneity < 0.0001). For mucinous cancers, incidence was increased in current versus never smokers (1.79, 95% CI 1.60-2.00, p < 0.0001), but the increase was mainly in borderline malignant rather than in fully malignant tumours (2.25, 95% CI 1.91-2.65 vs 1.49, 1.28-1.73; p heterogeneity =0.01; almost half the mucinous tumours were only borderline malignant). Both endometrioid (0.81, 95% CI 0.72-0.92, p=0.001) and clear-cell ovarian cancer risks (0.80, 95% CI 0.65-0.97, p=0.03) were reduced in current smokers, and there was no signifi cant association for serous ovarian cancers (0.99, 95% CI 0.93-1.06, p=0.8). These associations did not vary signifi cantly by 13 sociodemographic and personal characteristics of women including their body-mass index, parity, and use of alcohol, oral contraceptives, and menopausal hormone therapy. Interpretation The excess of mucinous ovarian cancers in smokers, which is mainly of tumours of borderline malignancy, is roughly counterbalanced by the defi cit of endometrioid and clear-cell ovarian cancers. The substantial variation in smoking-related risks by tumour subtype is important for understanding ovarian carcinogenesis.

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/20.500.14594/15124

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