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©The Author(s) 2023.
World J Meta-Anal. Jun 18, 2023; 11(5): 228-252
Published online Jun 18, 2023. doi: 10.13105/wjma.v11.i5.228
Published online Jun 18, 2023. doi: 10.13105/wjma.v11.i5.228
Table 1 Details of the 44 studies of lung cancer
Study IDa | Ref. | Country | Designb | Study Population | Start year | Year followed | Agec | Sexd | Cases | Adjuste | Exclf | Latencyg | Endpoint | NRRh |
ACE | [51,52] | US | Cohort | Regional | 1995 | 10 | 18+ | C | 111 | 0, 8 | 0 | 0 | Died | 2 |
AEROBIC | [53] | US | Cohort | Regional | 1974 | 29 | 20-84 | M | 232 | 0 | 0 | 0 | Died | 1 |
AGRICAN | [54] | France | Cohort | Regional | 2005 | 6 | 18+ | M, F | 664 | 1 | 0 | 0 | Diagnosed | 2 |
AHS | [55] | US | Cohort | Pesticide workers | 1993 | 18 | NAR | C | 789 | 0, 8 | x | 0 | Diagnosed | 2 |
AMIANT | [56] | Poland | Cohort | Asbestos workers | 2000 | 14 | NAR | C | 110 | 0 | 0 | 0 | Diagnosed | 1 |
ARIC | [57] | US | Cohort | Regional | 1987 | 19 | 45-64 | M, F | 470 | 0, 3 | 0 | 0 | Diagnosed | 4 |
ATP | [22] | Canada | Cohort | Regional | 2001 | 16 | 35-69 | M, F | 210 | 0, 1, 7 | 0 | 0, x | Diagnosed | 10 |
BIOBANK | [58] | UK | Cohort | National | 2006 | 10 | 40-73 | M, F | 1493 | 0 | 0 | 0 | Diagnosed | 2 |
BWHS | [59] | US | Cohort | National | 1995 | 18 | 21-69 | F | 306 | 0, 1, 7 | 0 | 0 | Diagnosed | 3 |
CHANCES | [21] | Multiple | Cohort | International | 1982 | 29 | 46-74 | C | 14041 | 0, 7 | 0 | 0 | Diag, died | 4 |
COAL | [60] | US | Cohort | Coal miners | 1969 | 38 | NAR | M | 568 | 7 | 0 | 0 | Died | 1 |
CPS-I | [26] | US | Cohort | National | 1959 | 6 | 49+ | M, F | 1293 | 0, 1, 3 | x | 0 | Died | 6 |
CPS-II | [26] | US | Cohort | National | 1982 | 6 | 49+ | M, F | 4957 | 0, 1, 3 | x | 0 | Died | 6 |
EPIC | [31] | Multiple | Cohort | International | 1991 | 14 | 35-70 | M | 2995 | 0, 5 | x | 0 | Diagnosed | 6 |
[32] | 8 | 30-70 | M, F | 2995 | 7 | 0 | 0 | Diagnosed | 2 | |||||
ESTHER | [61] | Germany | Nested CC | Regional | 2000 | 17 | 50-75 | C | 143 | 0 | 0 | 0 | Diagnosed | 1 |
FRAMING | [62] | US | Cohort | Regional | 1954 | 59 | NAR | C | 284 | 0, 1 | 0 | 0 | Diagnosed | 2 |
HBC | [63] | Finland | Cohort | Regional | 2001 | 5 | 55-65 | C | 121 | 1 | 0 | 0 | Diagnosed | 1 |
HPFS | [64] | US | Nested CC | Medical workers | 1986 | 14 | 40-75 | M | 210 | 0, 2, 4 | 0 | 0 | Diagnosed | 3 |
JP8 | [23] | Japan | Cohort | National | 1984 | 25 | 35+ | M, F | 4478 | 0, 2, 5 | x | 0, x | Diagnosed | 8 |
JPHC | [65] | Japan | Cohort | National | 1990 | 21 | 40-69 | M, F | 1663 | 0 | x | 0 | Diagnosed | 2 |
[66] | 3 | 40-69 | M, F | 1663 | 0, 10 | x | 0 | Died | 4 | |||||
KAISER | [67] | US | Cohort | Regional | 1978 | 30 | NAR | C | 1415 | 0, 6 | 0 | 0 | Diagnosed | 2 |
KRIS | [68] | Lithuania | Cohort | Regional | 1972 | 36 | 40-59 | M | 343 | 0, 1, 4 | 0 | x | Diagnosed | 3 |
LSS | [69] | Japan | Cohort | Atomic bomb survivors | 1950 | 59 | 5+ | M, F | 1597 | 0 | x | 0 | Diagnosed | 2 |
MWOMEN | [24] | UK | Cohort | National | 1996 | 15 | 50-69 | F | 6331 | 0, 10 | x | 0, x | Died | 3 |
NHANES | [70] | US | Cohort | National | 1988 | 18 | 40+ | C | 269 | 0 | 0 | 0 | Died | 1 |
NHIS | [71] | US | Cohort | National | 1987 | 28 | 18-84 | C | 7420 | 0, 11 | 0 | 0 | Died | 2 |
[72] | 9 | 25-79 | M, F | 7420 | 0, 4 | 0 | x | Died | 4 | |||||
NHS | [73] | US | Cohort | Medical workers | 1980 | 24 | 34-59 | F | 1729 | 1, 13 | 0 | 0 | Died | 2 |
[74] | 24 | 38-63 | F | 1729 | 0 | 0 | 0 | Diagnosed | 1 | |||||
NIHAARP | [75] | US | Cohort | Regional | 1995 | 11 | 50-71 | M, F | 17846 | 0, 5 | x | x | Diagnosed | 4 |
[76] | 16 | 50-71 | C | 17846 | 0 | 0 | 0 | Diagnosed | 1 | |||||
NLCS | [29] | Netherlands | Nested CC | National | 1986 | 17 | 55-69 | C | 3355 | 0 | 0 | 0 | Diagnosed | 3 |
[30] | 20 | 55-69 | M, F | 3355 | 0 | 0 | 0 | Diagnosed | 2 | |||||
NLMS | [28] | US | Cohort | National | 1985 | 26 | 35-80 | C | 3890 | 0, 1, 5 | x | 0 | Died | 8 |
NLST | [77] | US | Cohort | Construction workers | 1998 | 18 | NAR | M | 352 | 0, 2 | 0 | 0 | Died | 2 |
NONMET | [78] | US | Nested CC | Non-metal miners | 1947 | 50 | NAR | M | 198 | 0, 7 | 0 | 0 | Died | 2 |
NOWAC | [79] | Norway | Cohort | National | 1991 | 24 | 31-70 | F | 1507 | 0, 1, 3 | 0 | 0 | Diagnosed | 3 |
PLCO | [80] | US | Cohort | Regional | 1993 | 15 | 55-74 | C | 1040 | 0 | 0 | 0 | Died | 1 |
[81] | 15 | 55-74 | F | 1040 | 6 | 0 | 0 | Died | 1 | |||||
QRESEAR | [82] | UK | Cohort | National | 1998 | 15 | 25-84 | M, F | 32187 | 0, 6 | 0 | 0 | Diagnosed | 4 |
SCCS | [83] | US | Nested CC | Regional | 2002 | 14 | 40-79 | M, F | 1334 | 0 | 0 | 0 | Diagnosed | 2 |
[84] | 7 | 40-79 | C | 1334 | 10 | 0 | 0 | Diagnosed | 1 | |||||
SHEETME | [85] | Multiple | Cohort | Sheet metal workers | 1986 | 24 | NAR | M | 808 | 0 | 0 | 0 | Died | 1 |
THIN | [86] | UK | Cohort | National | 2000 | 12 | 30-99 | C | 1015 | 0 | 0 | 0 | Diagnosed | 1 |
THREEC | [20] | Norway | Cohort | Regional | 1974 | 33 | 20-49 | M | 858 | 0, 10 | 0, x | 0 | Died | 6 |
[87] | 35 | 35-49 | M, F | 858 | 0 | 0 | x | Died | 2 | |||||
USA5 | [26] | US | Cohort | National | 1986 | 24 | 45+ | M, F | 11420 | 0, 1, 3 | 0 | 0 | Died | 6 |
VETERAN | [88] | US | Cohort | Regional | 1987 | 28 | 21-89 | M | 105 | 0 | 0 | 0 | Diagnosed | 1 |
VITAL | [89] | US | Cohort | Regional | 2000 | 7 | 50-76 | C | 797 | 0 | 0 | 0 | Diagnosed | 1 |
VLAGT | [27] | Netherlands | Cohort | Regional | 1965 | 43 | 20-65 | M, F | 275 | 0, 3, 4 | 0 | 0 | Died | 4 |
WHI | [90] | US | Cohort | National | 1993 | 16 | 50-79 | F | 901 | 0, 1, 15 | 0 | 0 | Diagnosed | 3 |
Table 2 Details of the 18 studies of chronic obstructive pulmonary disease
Study IDa | Ref. | Country | Study Population | Start year | Year followed | Ageb | Sexc | Cases | COPD definitiond | Adjuste | Exclf | Latencyg | Endpoint | NRRh |
CPRD | [91] | UK | Regional | 2003 | 4 | 40-89 | C | 14446 | 3 | 0 | 0 | 0 | Diagnosed | 1 |
CPS-I | [26] | US | National | 1959 | 6 | 49+ | M, F | 782 | DU | 0, 1, 3 | 0, x | 0 | Died | 6 |
CPS-II | [26] | US | National | 1982 | 6 | 49+ | M, F | 2128 | DU | 0, 1, 3 | 0, x | 0 | Died | 6 |
Finn Twins | [92] | Finland | National | 1975 | 27 | 17+ | C | 511 | 5 | 0, 2 | 0 | 0 | Diagnosed | 2 |
JACC | [93] | Japan | National | 1988 | 20 | 40-79 | M, F | 285 | 6 | 0, 1, 9 | 0 | 0 | Died | 6 |
KAISER | [94] | US | Regional | 1978 | 28 | NAR | C | 778 | 4 | 0, 6 | 0 | 0 | Diagnosed | 2 |
MWOMEN | [24] | UK | National | 1996 | 15 | 50-69 | F | 1910 | 2 | 0, 5 | x | 0 | Died | 3 |
NHS-HPFS | [95] | US | Regional | 1976 | 24 | 30-75 | C | 832 | 1 | 0 | 0 | 0 | Diagnosed | 1 |
NIH-AARP | [96] | US | Regional | 1995 | 11 | 50-70 | C | 3648 | 1 | 0 | 0 | 0 | Diagnosed | 1 |
NLMS | [28] | US | National | 1985 | 26 | 35-80 | C | 2091 | 2 | 0, 1, 5 | x | 0 | Died | 9 |
NOWACi | [97] | Norway | National | 1991 | 17 | 26-71 | F | 68 | 2 | 1, 6 | x | 0 | Died | 2 |
PATH | [98] | US | National | 2013 | 3 | 18+ | C | 319 | 1 | 0 | 0 | 0 | Diagnosed | 1 |
SMC | [99] | Sweden | Regional | 1997 | 17 | 48-83 | F | 1495 | 8 | 0 | x | x | Diagnosed | 1 |
THIN | [86] | UK | National | 2000 | 12 | 30-99 | C | 3901 | 9 | 0 | 0 | 0 | Diagnosed | 1 |
USA5 | [26] | US | Regional | 1986 | 24 | 50+ | M, F | 9246 | DU | 0, 1, 3 | 0, x | 0 | Died | 6 |
[100] | 25 | 50+ | M, F | 9246 | 2 | 0, 5 | 0, x | 0 | Died | 4 | ||||
VLAGT | [27] | Netherlands | Regional | 1965 | 43 | NAR | M, F | 313 | 7 | 0, 3 | 0, x | 0 | Died | 4 |
WHI | [25] | US | Regional | 1993 | 22 | 50-79 | F | 4959 | 1 | 0 | x | 0 | Diagnosed | 1 |
WHS | [101] | US | Regional | 1993 | 11 | 45+ | F | 1604 | 1 | 0 | x | 0 | Diagnosed | 1 |
Table 3 Lung cancer and current vs never cigarette smoking – results from random effects meta-analyses
Full output table | Factor | Level | No. of RRs | No. of studies | RR (95%CI) | Heterogeneity test by level |
All | 62 | 44 | 12.14 (10.30-14.30) | P < 0.001 | ||
4 | Sex | Combined | 12 | 12 | 12.93 (10.55-15.84) | |
Males | 26 | 26 | 12.95 (9.82-17.08) | |||
Females | 24 | 24 | 11.32 (8.46-15.15) | NS | ||
5 | Region | N. America | 34 | 26 | 15.15 (12.77-17.96) | |
Europe | 21 | 14 | 12.30 (9.77-15.49) | |||
Japan | 6 | 3 | 3.61 (2.87-4.55) | |||
Multi | 1 | 1 | 13.10 (9.91-17.32) | P < 0.001 | ||
6 | Study population | International | 3 | 2 | 14.45 (6.85-30.50) | |
National | 25 | 16 | 10.26 (8.03-13.12) | |||
Regional | 24 | 17 | 16.27 (13.39-19.77) | |||
Specific | 10 | 9 | 9.71 (5.41-17.42) | P < 0.05 | ||
7 | Year of start of baseline | < 1980 | 14 | 10 | 8.65 (5.83-12.83) | |
1980-89 | 19 | 13 | 12.92 (9.83-16.98) | |||
1990-99 | 16 | 12 | 13.45 (9.76-18.53) | |||
2000+ | 13 | 9 | 14.38 (11.40-18.15) | NS trend P < 0.1 | ||
8 | Number of cases | < 500 | 19 | 16 | 11.90 (9.55-14.83) | |
500-1999 | 24 | 17 | 11.68 (8.65-15.75) | |||
2000+ | 19 | 11 | 12.76 (9.99-16.31) | NS trend NS | ||
9 | Exclusive cigarettes | No | 45 | 35 | 13.47 (11.55-15.72) | |
Yes | 17 | 11 | 9.50 (6.61-13.64) | P < 0.1 | ||
10 | Latency rule applied | No | 51 | 38 | 11.93 (9.97-14.28) | |
Yes | 11 | 7 | 13.13 (8.69-19.83) | NS | ||
11 | Study design | Cohort | 55 | 39 | 12.35 (10.35-14.73) | |
Nested case control | 7 | 5 | 10.41 (8.04-13.48) | NS | ||
12, 13 | Lowest age considered | < 30 | 15 | 10 | 11.30 (7.37-17.33) | |
30-39 | 11 | 8 | 11.41 (7.80-16.70) | |||
40-48 | 14 | 9 | 13.29 (9.15-19.30) | |||
49+ | 14 | 10 | 13.62 (10.22-18.16) | NS trend without | ||
Missing | 8 | 8 | 10.79 (7.64-15.23) | Missing NS | ||
14 | Year of follow-up | < 10 | 11 | 7 | 12.63 (8.49-18.80) | |
10- < 15 | 11 | 8 | 16.05 (12.48-20.65) | |||
15- < 20 | 14 | 11 | 16.05 (12.69-20.30) | |||
20- < 30 | 15 | 11 | 9.08 (6.26-13.15) | |||
30+ | 11 | 8 | 9.57 (6.01-15.26) | P < 0.05 trend P < 0.1 | ||
15 | Endpoint | Died | 23 | 17 | 14.85 (11.99-18.38) | |
Diagnosed | 39 | 27 | 10.82 (8.61-13.60) | P < 0.05 | ||
16 | Number of adjustment factors | None | 20 | 15 | 9.65 (7.13-13.05) | |
Age only | 4 | 3 | 11.80 (5.24-26.56) | |||
More | 38 | 28 | 13.68 (11.46-16.34) | NS trend P < 0.1 |
Table 4 Chronic obstructive pulmonary disease and current vs never cigarette smoking – results from random effects meta-analyses
Full output table | Factor | Level | No. of RRs | No. of Studies | RR (95%CI) | Heterogeneity test by level |
All | 23 | 18 | 9.19 (6.97-12.13) | P < 0.001 | ||
4 | Sex | Combined | 8 | 8 | 8.91 (7.05-11.26) | |
Males | 5 | 5 | 9.56 (4.22-21.64) | |||
Females | 10 | 10 | 9.33 (4.91-17.71) | NS | ||
5 | Region | N. America | 13 | 10 | 8.91 (5.73-13.84) | |
Europe | 8 | 7 | 10.63 (6.93-16.29) | |||
Japan | 2 | 1 | 6.00 (2.97-12.12) | NS | ||
6 | Study population | National | 12 | 9 | 8.90 (6.47-12.24) | |
Regional | 11 | 9 | 9.51 (6.16-14.66) | NS | ||
7 | Year of start | < 1988 | 12 | 8 | 10.24 (7.26-14.45) | |
of baseline | 1988+ | 11 | 10 | 8.14 (5.78-11.47) | NS | |
8 | Number of cases | < 1000 | 11 | 8 | 7.42 (5.65-9.74) | |
1000+ | 12 | 10 | 10.67 (7.26-15.68) | NS | ||
9 | Exclusive cigarettes | No | 13 | 12 | 9.02 (6.78-12.00) | |
Yes | 10 | 10 | 9.48 (5.25-17.14) | NS | ||
10 | Latency rule applied | No | 21 | 16 | 8.41 (6.38-11.09) | |
Yes | 2 | 2 | 21.67 (7.74-60.66) | P < 0.1 | ||
11, 12 | Lowest age considered | < 34 | 5 | 5 | 8.36 (7.13-9.80) | |
35-45 | 5 | 4 | 6.26 (4.31-9.08) | |||
46-49 | 5 | 3 | 7.92 (5.41-11.58) | |||
50+ | 5 | 4 | 15.36 (5.95-39.66) | NS trend without | ||
Missing | 3 | 2 | 9.33 (5.00-17.40) | Missing NS | ||
13 | Year of follow-up | < 10 | 6 | 4 | 6.85 (5.24-8.94) | |
10- < 20 | 6 | 6 | 11.32 (6.67-19.20) | |||
20- < 30 | 9 | 7 | 10.11 (5.21-19.60) | |||
30+ | 2 | 1 | 6.29 (3.73-10.59) | NS trend NS | ||
14 | COPD definitiona | Excl. Bronch | 6 | 5 | 17.45 (8.35-36.44) | |
Incl. Bronch | 5 | 3 | 7.83 (4.60-13.35) | |||
Other | 12 | 10 | 7.15 (5.19-9.84) | P < 0.1 | ||
15 | Endpoint | Died | 13 | 8 | 10.95 (7.42-16.15) | |
Diagnosed | 10 | 10 | 7.49 (5.63-9.95) | NS | ||
16 | Number of adjustment factors | None | 8 | 8 | 6.96 (5.09-9.53) | |
More | 15 | 10 | 10.83 (7.67-15.29) | P < 0.1 |
- Citation: Lee PN, Coombs KJ, Hamling JS. Evidence relating cigarette, cigar and pipe smoking to lung cancer and chronic obstructive pulmonary disease: Meta-analysis of recent data from three regions. World J Meta-Anal 2023; 11(5): 228-252
- URL: https://www.wjgnet.com/2308-3840/full/v11/i5/228.htm
- DOI: https://dx.doi.org/10.13105/wjma.v11.i5.228