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Are smoking women at higher risk than men for lung cancer?

Tuesday, October 25, 2011 — Poster Session II

Noon – 2:00 p.m.

Natcher Conference Center




  • S De Matteis
  • D Consonni
  • AC Pesatori
  • PA Bertazzi
  • N Caporaso
  • JH Lubin
  • S Wacholder
  • MT Landi


Women have been hypothesized to have higher lung cancer susceptibility to tobacco carcinogens compared to men, but epidemiological studies are conflicting. We tested this hypothesis in the large Environment And Genetics in Lung cancer Etiology (EAGLE) population-based case-control study. Separately for males and females, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for cumulative exposure to smoking (pack-years) by logistic regression adjusted for age, residence area, and time since quitting smoking, after evaluating several potential confounders, including tobacco type and inhalation depth. We tested gender-smoking interaction by including their product term in the models. Further, by using the sampling fractions among controls, we reconstructed lung cancer rates in the underlying population, to estimate rate ratios (RRs) and 95% CIs. ORs for categories of pack-years were higher in men (P-interaction=0.07). Restricted to ever smokers, ORs were higher in women, but with considerable CI overlap and no interaction (P=0.93). We obtained similar results for pack-years as a continuous (log-transformed) variable. The RRs confirmed the ORs, with negative female-smoking interaction (P<0.001 and P=0.01 for all subjects and ever smokers, respectively). Similar patterns were found across histological types. Our findings do not support a higher female susceptibility to tobacco-related lung cancer.

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