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Table 7 Stomach cancer; individual effect (relative risk/odds ratio) estimates

From: Systematic review of the relation between smokeless tobacco and cancer in Europe and North America

 

ST use

  

RR/OR

Sourcea

Typeb

Exposurec

Smoking

Sexd

Id.

Casese

Estimate (95%CI)d

Adjustment factorsf

Cohort studies

        

Lutheran Brotherhood: Kneller et al. 1991 [12]

ST

Ever

Any

M

1

18

1.60 (0.58–4.50)

age, byr, smok

   

Never

M

2

3

3.80 (1.00–14.32)

age, byr

US Veterans: Winn et al. 1982 [19]

ST

Ever

Never

Mg

3

NA

1.51 (NA)

age

CPS-II: Chao et al. 2002 [24]

ST

Current

Never

M

4

8

1.58 (0.76–3.28)

age, asp, diet, edu, fhis, race, vit

  

Former

  

5

2

1.11 (0.27–4.50)

 
  

Ever

  

6

10

1.45 (0.75–2.80)h

 

Norway cohorts: Boffetta et al. 2005 [26]

Snuff

Current

Any

M

7

42

1.00 (0.71–1.42)

age, smok

  

Former

  

8

32

1.29 (0.87–1.91)

 
  

Ever

  

9

74

1.11 (0.83–1.48)

 

Swedish construction workers: Zendehdel et al. 2008 [34]

Snuff

Ever

Any

M

10

311

1.08 (0.96–1.22)i

age, bmi, smok

  

Ever

Never

M

11

76

1.33 (1.03–1.72)j

age, bmi

Case-control studies

        

Bjelke 1974 (USA) [52]

Chew

Use

Any

NA

12

NA

no association

NA

Bjelke 1974 (Norway) [52]

Chew

Use

Any

NA

13

NA

association

NA

Williams and Horm 1977 [55]

ST

Ever

Any

M

14

12

1.31 (0.71–2.43)h

age, race, smok

    

F

15

2

1.50 (0.36–6.26)

none

Weinberg et al. 1985 [67]

Chew

Ever

Any

M

16

NA

no association

none

Hansson et al. 1994 [94]

Snuff

Use

Any

M+F

17

NA

0.70 (0.47–1.06)

age, ses, sex, smok

Ye et al. 1999 [107]

Chew

Ever

Any

M+F

18

8

1.30 (0.54–3.12)h

none

 

Snuff

Ever

 

M

19

83

0.77 (0.56–1.06)h

age, alc, bmi, res, ses, smok

   

Never

M

20

11

0.50 (0.20–1.20)

age, alc, bmi, res, ses

Lagergren et al. 2000 [108]

Snuff

Ever

Any

M+F

21

53

1.20 (0.80–1.80)

age, alc, bmi, diet, edu, exer, rflx, sex, smok

  1. a Fuller details of the studies are given in Tables 1 and 2.
  2. b ST implies smokeless tobacco unspecified, or combined snuff use or chewing.
  3. c Ever, former and current ST use were compared with never ST. Use indicates timing not given and comparison is with non use.
  4. d NA = not available.
  5. e 'Id.' is the RR/OR identification number used in Table 8, and 'Cases' is the number of cases in ST users as defined. NA = not available.
  6. f Abbreviations used: alc = alcohol, asp = aspirin, bmi = body mass index, byr = birth year, edu = education, exer = exercise, fhis = family history of stomach cancer, incm = incidence or mortality, res = area of residence, rflx = reflux symptoms, ses = socioeconomic status, smok = smoking, vit = vitamins, NA = not available.
  7. g The population included < 0.5% females.
  8. h Estimated from data provided in the source.
  9. i RRs for cardia (1.0, 95% CI 0.8–1.4) and noncardia stomach cancer (1.1, 1.0–1.3) combined.
  10. j RRs for cardia (0.9, 95% CI 0.4–2.0) and noncardia stomach cancer (1.4, 1.1–1.9) combined.
  11. CI = confidence interval; ST = smokeless tobacco; OR = odds ratio; RR = relative risk.