Quantitative association of tobacco smoking with the risk of nasopharyngeal carcinoma: A comprehensive meta-analysis of studies conducted between 1979 and 2011

Wen Qiong Xue, Hai De Qin, Hong Lian Ruan, Yin Yao Shugart, Wei Hua Jia

Research output: Contribution to journalArticle

Abstract

Over the years, many studies have attempted to establish a link between tobacco smoking and an increased risk of nasopharyngeal carcinoma (NPC), but their results have been inconsistent. To clarify this link, we first conducted a comprehensive meta-analysis to integrate the findings of epidemiologic studies from the last half-century. The methodology used for this study followed the checklist proposed by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) Group. Pooled risk estimates were generated using a random-effects model. Twenty-eight case-control studies and 4 cohort studies involving a total of 10,274 NPC cases and 415,266 comparison subjects were included. A substantial effect of smoking on the risk of NPC was identified in this study. The results showed that ever smokers had a 60% greater risk of developing the disease than never smokers (95% confidence interval: 1.38, 1.87); this was a robust dose-dependent association. More importantly, stronger associations were observed in low-risk populations and among persons with the predominant histological type of differentiated NPC than in high-risk populations and persons with an undifferentiated type; the odds ratios were 1.76 and 2.20, respectively, versus 1.29 and 1.27. In this comprehensive meta-analysis, well-established statistical evidence was provided about the role of tobacco smoking in the etiology of NPC.

Original languageEnglish (US)
Pages (from-to)325-338
Number of pages14
JournalAmerican Journal of Epidemiology
Volume178
Issue number3
DOIs
StatePublished - Aug 1 2013
Externally publishedYes

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Meta-Analysis
Smoking
Checklist
Population
Observational Studies
Nasopharyngeal carcinoma
Case-Control Studies
Epidemiologic Studies
Epidemiology
Cohort Studies
Odds Ratio
Confidence Intervals

Keywords

  • case-control studies
  • cohort studies
  • meta-analysis
  • nasopharyngeal carcinoma
  • odds ratio
  • tobacco smoking

ASJC Scopus subject areas

  • Epidemiology

Cite this

Quantitative association of tobacco smoking with the risk of nasopharyngeal carcinoma : A comprehensive meta-analysis of studies conducted between 1979 and 2011. / Xue, Wen Qiong; Qin, Hai De; Ruan, Hong Lian; Shugart, Yin Yao; Jia, Wei Hua.

In: American Journal of Epidemiology, Vol. 178, No. 3, 01.08.2013, p. 325-338.

Research output: Contribution to journalArticle

Xue, Wen Qiong ; Qin, Hai De ; Ruan, Hong Lian ; Shugart, Yin Yao ; Jia, Wei Hua. / Quantitative association of tobacco smoking with the risk of nasopharyngeal carcinoma : A comprehensive meta-analysis of studies conducted between 1979 and 2011. In: American Journal of Epidemiology. 2013 ; Vol. 178, No. 3. pp. 325-338.
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