Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium

Ordóñez-Mena, José Manuel; Schöttker, Ben; Mons, Ute; Jenab, Mazda; Freisling, Heinz; Bueno-de-Mesquita, Bas; O’Doherty, Mark G.; Scott, Angela; Kee, Frank; Stricker, Bruno H.; Hofman, Albert; de Keyser, Catherine E.; Ruiter, Rikje; Söderberg, Stefan; Jousilahti, Pekka; Kuulasmaa, Kari; Freedman, Neal D.; Wilsgaard, Tom; de Groot, Lisette CPGM; Kampman, Ellen; Håkansson, Niclas; Orsini, Nicola; Wolk, Alicja; Nilsson, Lena Maria; Tjønneland, Anne; Pająk, Andrzej; Malyutina, Sofia; Kubínová, Růžena; Tamosiunas, Abdonas; Bobak, Martin; Katsoulis, Michail; Orfanos, Philippos; Boffetta, Paolo; Trichopoulou, Antonia; Brenner, Hermann

doi:10.1186/s12916-016-0607-5

Table 2 Associations of smoking status and time since smoking cessation with total, lung, head and neck cancer incidence and mortality^a,b

From: Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium

Cancer site	Smoking exposure	Cancer incidence				Cancer mortality
Cancer site	Smoking exposure	Total^c	Cases	HR (95 % CI)	RAP (95 % CI)	Total^c	Cases	HR (95 % CI)	RAP (95 % CI)
Total cancer	Smoking status
	Never	321984	43449	1.00 (reference)	0.00 (reference)	346559	13398	1.00 (reference)	0.00 (reference)
	Former	353311	64797	1.15 (1.09 ; 1.21) ^***	2.67 (1.65 ; 3.70) ^**	368808	24365	1.39 (1.26 ; 1.54) ^***	4.03 (2.85 ; 5.22) ^***
	Current	128615	26007	1.44 (1.28 ; 1.63) ^***	7.92 (5.58 ; 10.3) ^***	140672	13450	2.19 (1.83 ; 2.63) ^***	9.92 (7.84 ; 12.0) ^***
	Years since smoking cessation (reference: current smokers)^d
	≤9 years	19049	2704	0.90 (0.86 ; 0.94)	-1.62 (-2.41; -0.83)	22693	1351	0.83 (0.77 ; 0.89)	-2.09 (-2.86 ; -1.31)
	10–19 years	18511	2613	0.80 (0.74 ; 0.88) ^**	-4.01 (-5.73; -2.29) ^**	21361	1145	0.66 (0.59 ; 0.73)	-4.81 (-6.01 ; -3.62)
	≥20 years	24651	3904	0.75 (0.70 ; 0.81) ^**	-5.27 (-6.69; -3.86) ^*	28057	1507	0.52 (0.47 ; 0.58) ^*	-7.54 (-8.59 ; -6.49)
	P linear trend			<0.0001				<0.0001
Lung cancer	Smoking status
	Never	321984	923	1.00 (reference)	0.00 (reference)	346559	863	1.00 (reference)	0.00 (reference)
	Former	353311	6785	4.06 (3.13 ; 5.26) ^**	16.4 (12.2 ; 20.7) ^***	368808	6967	4.10 (3.14 ; 5.36) ^***	15.3 (11.7; 18.9) ^**
	Current	128615	6333	13.1 (9.90 ; 17.3) ^***	30.0 (24.1 ; 35.9) ^***	140672	6165	11.5 (8.21 ; 16.1) ^***	26.2 (21.5; 30.8) ^***
	Years since smoking cessation (reference: current smokers)^d
	≤9 years	19049	306	0.60 (0.48 ; 0.73) ^*	-5.26 (-7.91; -2.61) ^*	22693	373	0.70 (0.56 ; 0.87) ^**	-3.45 (-5.33 ; -1.56)
	10–19 years	18511	191	0.33 (0.25 ; 0.44) ^**	-12.3 (-16.4; -8.20) ^**	21361	233	0.40 (0.31 ; 0.51) ^*	-8.99 (-12.2 ; -5.77) ^**
	≥20 years	24651	139	0.15 (0.12 ; 0.19)	-21.9 (-28.1; -15.8) ^**	28057	168	0.18 (0.14 ; 0.24) ^*	-17.0 (-21.3 ; -12.7) ^**
	P linear trend			<0.0001				<0.0001
Head and neck cancer	Smoking status
	Never	321984	636	1.00 (reference)	0.00 (reference)	346559	155	1.00 (reference)	0.00 (reference)
	Former	353311	1503	1.73 (1.57 ; 1.92)	7.77 (4.24 ; 11.3)	368808	388	2.10 (1.70 ; 2.61)	9.01 (4.36 ; 13.6)
	Current	128615	1051	2.89 (1.98 ; 4.21) ^**	9.10 (-2.34 ; 20.5)^***	140672	359	3.74 (2.38 ; 5.89)	14.0 (4.53 ; 23.5) ^**
	Years since smoking cessation (reference: current smokers)^d
	≤9 years	19049	64	1.08 (0.80 ; 1.47)	-0.77 (-3.97 ; 3.66)	22693	22	1.35 (0.75 ; 2.44)	-2.64 (-4.11 ; 9.40)
	10–19 years	18511	33	0.61 (0.40 ; 0.92)	-5.71 (-15.4 ; 1.19)	21361	14	1.35 (0.62 ; 2.90)	3.45 (-7.93 ; 14.8)
	≥20 years	24651	53	0.55 (0.34 ; 0.91)	-2.75 (-9.26 ; 3.76)	28057	20	0.58 (0.31 ; 1.07)	-3.59 (-10.1 ; 2.91)
	P linear trend			0.0039				0.0676

^aNumbers in bold denote statistical significance (P < 0.05). Heterogeneity was regarded as negligible if not significant (P < 0.05) or I² < 30 %. Otherwise, if significant (P < 0.05), it was classified as ^* moderate (30 % < I² < 50 %), ^** substantial (50 % < I² < 75 %), or ^*** considerable (I² > 75 %)
^bCohort-specific Hazard Ratios (HRs) and Rate Advancement Periods (RAPs) were summarized with meta-analyses using random effects models. HRs and RAPs were adjusted for sex, age, BMI, education, vigorous physical activity, history of diabetes, and alcohol consumption
^cThe total number of participants for the analyses with cancer incidence is smaller because the participants with a diagnosis of cancer before baseline were excluded. Furthermore, some cohorts (HAPIEE and SENECA cohorts) had no cancer incidence data available for the analyses
^dFor the analyses with the categories of years since smoking cessation, the data from the NIH-AARP and MORGAM FI were not included because of the different categories employed
HAPIEE Health, Alcohol and Psychosocial Factors in Eastern Europe, SENECA Survey in Europe on Nutrition and the Elderly a Concerned Action, NIH-AARP National Institute of Health – American Association of Retired Persons, MORGAM Monica Risk, Genetics, Archiving and Monograph, which included the cohort MORGAM FI FINRISK Study (Finland)

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ISSN: 1741-7015

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