Geen vermindering longkanker bij nooit-rokers

Ondanks dat sinds 1970 roken in het openbaar steeds meer is afgenomen, is het aantal longkankergevallen onder vrouwen die nooit gerookt hebben licht gestegen en onder nooit-rokende mannen gelijk gebleven.


Dit onderzoeksresultaat staat in schrille tegenstelling tot beweringen dat meeroken longkanker zou veroorzaken bij nooit-rokers. Was dit immers het geval geweest, dan zouden na alle ingevoerde rookverboden in de afgelopen decennia, het aantal longkanker gevallen moeten hebben afgenomen.


BACKGROUND:


Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking.


METHODS:


We measured age-, sex-, and race-specific rates (per 100,000 person-years at risk) of death from lung cancer among more than 940,000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959-1972 (CPS-I) and 1982-2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided.


RESULTS:


The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100,000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70-84 years (P < .001).


CONCLUSIONS:


Contrary to clinical perception, the lung cancer death rate is not higher in female than in male never smokers and shows little evidence of having increased over time in the absence of smoking. Factors that affect the interpretation of lung cancer trends are discussed. Our novel finding that lung cancer mortality is higher among African American than white women never smokers should be confirmed in other studies.


PubMed

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  • "Es ist schwieriger, eine vorgefaßte Meinung zu zertrümmern als ein Atom."
    (Het is moeilijker een vooroordeel aan flarden te schieten dan een atoom.)
    Albert Einstein

  • "Als je alles zou laten dat slecht is voor je gezondheid, dan ging je kapot"
    Anonieme arts

  • "The effects of other people smoking in my presence is so small it doesn't worry me."
    Sir Richard Doll, 2001

  • "Een leugen wordt de waarheid als hij maar vaak genoeg wordt herhaald"
    Joseph Goebbels, Minister van Propaganda, Nazi Duitsland


  • "First they ignore you, then they laugh at you, then they fight you, then you win."
    Mahatma Gandhi

  • "There''s no such thing as perfect air. If there was, God wouldn''t have put bristles in our noses"
    Coun. Bill Clement

  • "Better a smoking freedom than a non-smoking tyranny"
    Antonio Martino, Italiaanse Minister van Defensie

  • "If smoking cigars is not permitted in heaven, I won't go."
    Mark Twain

  • I've alllllllways said that asking smokers "do you want to quit?" and reporting the results of that question, as is, is horribly misleading. It's a TWO part question. After asking if one wants to quit it must be followed up with "Why?" Ask why and the majority of the answers will be "because I'm supposed to" (victims of guilt and propaganda), not "because I want to."
    Audrey Silk, NYCCLASH