TY - JOUR
T1 - Analysis of lung cancer incidence in the nurses' health and the health professionals' follow-up studies using a multistage carcinogenesis model
AU - Meza, Rafael
AU - Hazelton, William D.
AU - Colditz, Graham A.
AU - Moolgavkar, Suresh H.
N1 - Funding Information:
Acknowledgments We thank the Cancer Intervention and Surveillance Modeling Network (CISNET) Group, Dr. Anup Dewanji and Dr. Jihyoun Jeon for useful suggestions. We acknowledge support from the NIH grants RO1 CA047658 and UO1 CA97415. Financial support: NIH grants RO1 CA047658 and UO1 CA97415.
PY - 2008/4
Y1 - 2008/4
N2 - We analyzed lung cancer incidence among non-smokers, continuing smokers, and ex-smokers in the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) using the two-stage clonal expansion (TSCE) model. Age-specific lung cancer incidence rates among non-smokers are identical in the two cohorts. Within the framework of the model, the main effect of cigarette smoke is on the promotion of partially altered cells on the pathway to cancer. Smoking-related promotion is somewhat higher among women, whereas smoking-related malignant conversion is somewhat lower. In both cohorts the relative risk for a given daily level of smoking is strongly modified by duration. Among smokers, the incidence in NHS relative to that in HPFS depends both on smoking intensity and duration. The age-adjusted risk is somewhat larger in NHS, but not significantly so. After smokers quit, the risk decreases over a period of many years and the temporal pattern of the decline is similar to that reported in other recent studies. Among ex-smokers, the incidence in NHS relative to that in HPFS depends both on previous levels of smoking and on time since quitting. The age-adjusted risk among ex-smokers is somewhat higher in NHS, possibly due to differences in the age-distribution between the two cohorts.
AB - We analyzed lung cancer incidence among non-smokers, continuing smokers, and ex-smokers in the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) using the two-stage clonal expansion (TSCE) model. Age-specific lung cancer incidence rates among non-smokers are identical in the two cohorts. Within the framework of the model, the main effect of cigarette smoke is on the promotion of partially altered cells on the pathway to cancer. Smoking-related promotion is somewhat higher among women, whereas smoking-related malignant conversion is somewhat lower. In both cohorts the relative risk for a given daily level of smoking is strongly modified by duration. Among smokers, the incidence in NHS relative to that in HPFS depends both on smoking intensity and duration. The age-adjusted risk is somewhat larger in NHS, but not significantly so. After smokers quit, the risk decreases over a period of many years and the temporal pattern of the decline is similar to that reported in other recent studies. Among ex-smokers, the incidence in NHS relative to that in HPFS depends both on previous levels of smoking and on time since quitting. The age-adjusted risk among ex-smokers is somewhat higher in NHS, possibly due to differences in the age-distribution between the two cohorts.
KW - Ex-smokers relative risk
KW - Lung cancer age-specific incidence
KW - Lung cancer epidemiology
KW - Multistage carcinogenesis
KW - Never smokers lung cancer risk
KW - Smokers relative risk
KW - Two-stage clonal expansion model
UR - http://www.scopus.com/inward/record.url?scp=40949098701&partnerID=8YFLogxK
U2 - 10.1007/s10552-007-9094-5
DO - 10.1007/s10552-007-9094-5
M3 - Article
C2 - 18058248
AN - SCOPUS:40949098701
SN - 0957-5243
VL - 19
SP - 317
EP - 328
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 3
ER -