Virtual Library
Start Your Search
Xiao Nan Cui
Author of
-
+
P2.10 - Prevention and Tobacco Control (ID 176)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.10-16 - Lung Cancer Occurrence Attributable to Passive Smoking Among Never Smokers in China: A Systematic Review and Meta-Analysis (ID 1946)
10:15 - 18:15 | Author(s): Xiao Nan Cui
- Abstract
Background
Quantifying lung cancer occurrence due to passive smoking is a necessary step for policy makers. The aim of this study is to estimate the proportion of lung cancer cases attributable to passive smoking among never smokers in China.
Method
A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We comprehensively searched six databases up to July 2019 for original observational studies in both English and Chinese languages. Studies that reported relative risks (RR) or odds ratios (OR) for lung cancer occurrence associated with passive smoking in Chinese never smokers were included. For each selected publication, two reviewers assessed publications in English and Chinese independently and assessed the quality of included studies using the Newcastle-Ottawa Scale (NOS). Any disagreements encountered were settled through a consensus. The population attributable fraction (PAF) was calculated using the combined proportion of lung cancer cases exposed to passive smoking and the pooled OR yielded from meta-analysis under the assumption of homogeneity.
Result
Thirty-one studies (all designed as case-control) were identified, comprising 9,614 cases and 13,093 controls. The overall proportion of lung cancer cases among never smokers attributable to passive smoking was estimated at 20.5% (95% CI: 16.0% - 24.7%), based on the proportion of lung cancer cases exposed to passive smoking (61.6%) and the pooled OR for passive smoking and lung cancer risk of 1.50 (95% CI: 1.35-1.76). ). The PAF was 15.5% (95%CI: 9.3%-21.0%) based on population-based studies and was 22.7% (95%CI: 16.6%-28.0%) based on hospital-based studies. The subgroup analysis (Table 1) showed that the PAF was similar in non-smoking men (20.9%) and women (21.3%). The proportion of lung cancer cases attributable to household passive smoking was much higher than workplace passive smoking (19.2% vs 10.5%).
Table 1 Population attributable fraction (PAF) of lung cancer caused by passive smoking among never smokers in subgroups subgroup
No. of studies
NOS score
cases
cases_
exposed
cases-exposed(%)
Pooled OR
95%CI
I2
P
PAF
95%CI
Study year
before 2000
13
6.23
2600
1639
63.04%
1.70
1.43-2.03
48.40%
0.025
25.96%
18.96% - 31.99%
after 2000
20
5.57
7000
4348
62.11%
1.50
1.31-1.72
67.60%
<0.001
20.70%
14.70% - 26.00%
Gender
men
9
6.22
809
473
58.47%
1.55
1.10-2.19
62.00%
0.007
20.75%
5.32% - 31.77%
women
26
5.77
7248
4803
66.27%
1.49
1.34-1.66
47.80%
0.004
21.79%
16.81% - 26.35%
Region
mainland
23
5.83
6468
3925
60.68%
1.55
1.35-1.79
67.60%
<0.001
21.53%
15.73% - 26.78%
non-mainland*
10
5.80
3132
2062
65.84%
1.61
1.36-1.90
49.00%
0.039
24.94%
17.43% - 31.19%
Exposure age
childhood/adulthood
5
6.40
1219
972
79.74%
1.50
1.14-1.96
52.70%
0.078
26.58%
9.79% - 39.06%
childhood
4
6.50
654
315
48.17%
1.50
1.08-2.10
43.30%
0.152
16.06%
3.57% - 25.23%
adulthood
5
6.60
835
517
61.92%
1.65
1.05-2.58
69.70%
0.010
24.39%
2.95% - 37.92%
Cancer type
all types
28
5.89
7642
4759
62.27%
1.62
1.44-1.82
59.80%
<0.001
23.83%
19.03% - 28.06%
adenocarcinoma
10
6.10
2485
1627
65.47%
1.52
1.20-1.91
67.80%
0.001
22.40%
10.91% - 31.19%
squamous cell carcinoma
3
6.67
101
57
56.44%
1.36
0.80-2.32
0.00%
0.400
14.94%
-14.11% - 32.11%
Publication language
EN
22
5.87
7082
4633
65.42%
1.40
1.27-1.54
35.40%
0.049
18.69%
13.91% - 22.94%
CN
11
5.72
2518
1354
53.77%
1.99
1.63-2.42
55.90%
0.012
26.75%
20.78% - 31.55%
Source of passive smoking
household/workplace
19
5.73
5183
3668
70.77%
1.70
1.46-1.99
72.20%
<0.001
29.14%
22.30% - 35.21%
household
7
6.14
1170
595
50.85%
1.67
1.32-2.10
41.40%
0.115
20.40%
12.33% - 26.64%
workplace
5
6.40
1178
245
20.80%
2.01
1.62-2.50
0.00%
0.514
10.45%
7.96% - 12.48%
Study setting
hospital-based
24
5.60
7428
4767
64.18%
1.67
1.47-1.9
68.50%
<0.001
25.75%
20.52% - 30.40%
population-based
9
6.44
2172
1220
56.17%
1.31
1.14-1.51
0.00%
0.464
13.29%
6.90% - 18.97%
Conclusion
Around 20% of lung cancer cases in never smokers, both men and women, are potentially attributable to passive smoking in China. These lung cancer cases in never smokers might be potentially prevented by eliminating exposure to passive smoking, in particular with regards to household passive smoking.
