GeYu Peng, Gaeun Lee, Sohyun Kim, Qiao-Yi Chen, Yooheon Park, NaNa Keum
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The SRR was 1.08 (95% CI = 1.02-1.14, p < 0.05, I<sup>2</sup> = 54%) for smoking initiated at age ≤ 15 years, 1.10 (95% CI = 1.07-1.14, p < 0.001, I<sup>2</sup> = 32%) for smoking initiated at age 15-20 years, and 1.08 (95% CI = 1.04-1.12, p < 0.001, I<sup>2</sup> = 42%) for smoking initiated at age ≥ 20 years. When timing of smoking initiation was defined relative to first childbirth, SRR was 1.10 (95% CI = 1.05-1.15, p < 0.001, I<sup>2</sup> = 34%) for smoking initiated before first childbirth, and 1.05 (95% CI = 0.99-1.11, p = 0.13, I<sup>2</sup> = 39%) for smoking initiated after first childbirth.</p><p><strong>Conclusions: </strong>Smoking, regardless of age of initiation, may increase breast cancer risk. 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引用次数: 0
摘要
背景：越来越多的证据表明吸烟会增加患乳腺癌的风险。尽管在世界范围内青少年吸烟的增加，潜在的异质性的关系，吸烟开始的时间还没有被系统地评估。方法：截至2024年1月，检索PubMed和Embase相关流行病学研究。采用dersimonan - laird随机效应模型，根据开始吸烟年龄（≤15岁、15-20岁、≥20岁）估计总相对危险度（SRR）和95%置信区间（CI）。结果：共纳入30项病例对照研究和20项队列研究。≤15岁开始吸烟的SRR为1.08 (95% CI = 1.02-1.14, p 2 = 54%)， 15-20岁开始吸烟的SRR为1.10 (95% CI = 1.07-1.14, p 2 = 32%)，≥20岁开始吸烟的SRR为1.08 （95% CI = 1.04-1.12, p 2 = 42%）。当开始吸烟的时间与第一次分娩相关时，第一次分娩前开始吸烟的SRR为1.10 (95% CI = 1.05-1.15, p 2 = 34%)，第一次分娩后开始吸烟的SRR为1.05 （95% CI = 0.99-1.11, p = 0.13, I2 = 39%）。结论：吸烟，不论开始吸烟的年龄，都可能增加患乳腺癌的风险。有必要进行更多的研究来阐明，与第一次分娩相比，开始吸烟的时间如何改变吸烟与乳腺癌风险之间的关系。
Meta-analysis of smoking and breast cancer risk: by age of smoking initiation.
Background: Mounting evidence suggests that smoking increases breast cancer risk. Despite a worldwide increase in adolescent smoking, potential heterogeneity in the relationship by timing of smoking initiation has not been systematically evaluated.
Methods: PubMed and Embase were searched through January 2024 for relevant epidemiologic studies. The summary relative risk (SRR) and 95% confidence interval (CI) were estimated by smoking initiation age (≤ 15 years, 15-20 years, ≥ 20 years) using the DerSimonian-Laird random-effects model.
Results: A total of 30 case-control studies and 20 cohort studies were included. The SRR was 1.08 (95% CI = 1.02-1.14, p < 0.05, I2 = 54%) for smoking initiated at age ≤ 15 years, 1.10 (95% CI = 1.07-1.14, p < 0.001, I2 = 32%) for smoking initiated at age 15-20 years, and 1.08 (95% CI = 1.04-1.12, p < 0.001, I2 = 42%) for smoking initiated at age ≥ 20 years. When timing of smoking initiation was defined relative to first childbirth, SRR was 1.10 (95% CI = 1.05-1.15, p < 0.001, I2 = 34%) for smoking initiated before first childbirth, and 1.05 (95% CI = 0.99-1.11, p = 0.13, I2 = 39%) for smoking initiated after first childbirth.
Conclusions: Smoking, regardless of age of initiation, may increase breast cancer risk. More studies are warranted to clarify how the timing of smoking initiation relative to first childbirth modifies the relationship between smoking and breast cancer risk.
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