A case-control study of lung cancer among Czech women

Few data are available to explain the continuing increase in lung cancer mortality among Czech women. Thr study was designed to examine the role of active smoking and other known or suspected factors. Data collected by personal interviews during the 15 months of a hospital-based case control study are reported. A total of 140 microscopically confirmed cases and 280 Frequency-matched controls were analysed using multiple logistic regression. Cigarette smoking was the most important factor associated with excess risk for lung cancer among women. Significantly increased risk was Found both among current smokers (OR = 11.20, 95%, CI 5.9-21.2). and ex-smokers (OR = 10.02. 95% CI 5.5-18.4). Positive dose-response gradients (P < 0.001) were observed between lung cancer risk and the daily number of cigarettes. duration of smoking, number of pack-years, inhaling, and grade of nicotine dependence assessed by the Fagerstrom test (Heatherton TF, Kozlowski LT, Frecker RC. Fagerstrom KO. Br J Addict 1991:86:1119-1470: Pomerleau OF. In: Bolliger CT, Fagerstrom KO, editors. The Tobacco Epidemic. Basle: Karger 1997. 122-131). Exposure to environmental smoke was associated with elevated lung cancer risk (OR = 3.58. for lifetime non-smokers exposed both in childhood and in adult age). Physical exercise and body mass index were inversely associated with lung cancer risk. For the category of physical exercise of more than 5 h per week. the odds ratio was 0.38. compared to subjects admitting no physical exercise. For body mass index. the odds ratio for the highest (compared to the lowest) quartile was 0.50. Chronic cough and phlegm (at least 3 months: per year) were associated with excess risk (OR = 6.07) only if their duration was less than 2 years before diagnosis of lung cancer. and, therefore, they were suspected of being more likely early symptoms of preclinical lung cancer rather than its cause. Our results support the statement that cigarette smoking is by far the most important cause of the on-going epidemic of lung cancer among Czech women, and are consistent with the concept of a balance between risk and protective factors whose eventual maintenance or alteration determine the development of disease las suggested by Rylander R, Axelsson G, Andersson L, Liljequist T. Bergman B. Lune Cancer 1996:14(Suppl 1): S75-S83). Concerted control of smoking appears to be an urgent priority in lung cancer prevention among women, including specific approaches targeted on the: female population. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.