학술논문
Association between waterpipe smoking and lung cancer: a multicentre case-control study in Iran.
Document Type
Academic Journal
Author
Rashidian H; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Hadji M; Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Ansari-Moghaddam A; Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.; Bakhshi M; Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.; Nejatizadeh A; Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.; Marzban M; Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Department of Public Health, School of Public Health, Bushehr University of Medical Science, Bushehr, Iran.; Rezaianzadeh A; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.; Seyyedsalehi MS; Department of Medical and Surgical Sciences, University of Bologna, Italy; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.; Moradi A; Golestan University of Medical Sciences, Gorgan, Iran.; Gholipour M; Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.; Alizadeh-Navaei R; Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.; Freedman ND; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.; Malekzadeh R; Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Etemadi A; Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA; Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Kamangar F; Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA.; Weiderpass E; International Agency for Research on Cancer, Lyon, France.; Pukkala E; Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.; Boffetta P; Department of Medical and Surgical Sciences, University of Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA. Electronic address: paolo.boffetta@mssm.edu.; Zendehdel K; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical and Surgical Sciences, University of Bologna, Italy. Electronic address: kzendeh@sina.tums.ac.ir.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0376507 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5616 (Electronic) Linking ISSN: 00333506 NLM ISO Abbreviation: Public Health Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: This study investigated the association between lung cancer and waterpipe smoking, which is an emerging global public health concern.
Study Design: Multicentre case-control study.
Methods: This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users.
Results: The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5).
Conclusions: Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
(Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)
Study Design: Multicentre case-control study.
Methods: This study included 627 cases and 3477 controls from the Iranian Study of Opium and Cancer (IROPICAN) study, which was conducted between 2017 and 2020. One frequency-matched control for each lung cancer patient was selected by age, gender and residential place; however, this study used controls of four cancer types in the analyses. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence intervals (CIs). Additional analyses were performed among 181 lung cancer cases and 2141 controls who were not cigarette smokers or opium or nass/pipe users.
Results: The odds of lung cancer were higher among waterpipe smokers than never-smokers (OR = 1.3, 95% CI: 1.0-1.7). Results showed a higher OR of lung cancer for those who smoked the waterpipe daily (OR = 2.1, 95% CI: 1.4-3.0), smoked more than two heads per day (OR = 2.7, 95% CI: 1.8-4.0), had smoked for >20 years (OR = 1.9, 95% CI: 1.3-2.7), smoked more than 20 head-years (OR = 2.8, 95% CI: 1.9-4.1) and initiated smoking before the age of 30 years (OR = 1.7, 95% CI: 1.1-2.5). The association was only statistically significant for squamous cell carcinomas (OR = 1.8, 95% CI 1.2-2.7). Furthermore, this study observed a higher OR of lung cancer among exclusive waterpipe smokers (OR = 2.3, 95% CI: 1.6, 3.5).
Conclusions: Waterpipe smoking was associated with an increased risk of lung cancer. The association was stronger with higher frequency, duration and intensity of exposure to waterpipe smoking. The association increases in exclusive waterpipe smokers, which is likely due to controlling for residual confounding by cigarette smoking and opium consumption, and higher exposure levels in this subpopulation.
(Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)