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Relative and Absolute Risks of Cigarette Smoking on Major Histologic Types of Lung Cancer in Korean Men

¹ Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea and ² National Health Insurance Corporation, Seoul, South Korea

Requests for reprints: Young Ho Yun, Quality of Cancer Care Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang-si, 411-769 Gyeonggi-do, South Korea. Phone: 82-31-920-1705; Fax: 82-31-920-2199. E-mail: lawyun{at}ncc.re.kr

Objectives: Most prospective cohort studies of lung cancer focus on the relative risk rather than the absolute risk of smoking.

Methods: This prospective study included 437,976 Korean men (cohort for the National Health Insurance Cooperation Study), 40 years old, who were free of cancer and smoking-related chronic disease at the time of enrollment. Based on new incidence cases, relative risk and excess risk, and their 95% confidence intervals (95% CI), were estimated with the standard Poisson regression model after adjustment for age or other demographic factors and other confounders.

Results: During the 6-year follow-up period of 3,142,451 person-years, 1,357 new lung cancer cases were identified. Based on the multivariate-adjusted relative risk for current smokers, the strongest association with smoking was shown for small-cell lung cancer (relative risk, 21.7; 95% CI, 8.0-58.5) followed by squamous cell carcinoma (relative risk, 11.7; 95% CI, 7.1-19.4) and then adenocarcinoma (relative risk, 2.1; 95% CI, 1.6-2.7). In current smokers with 40 pack-years of exposure, excess risk was highest for squamous cell carcinoma (excess risk, 33.8; 95% CI, 10.2-109.8) followed by adenocarcinoma (excess risk, 26.7; 95% CI, 10.3-64.4), and then small-cell carcinoma (excess risk, 16.3; 95% CI, 1.8-144.3).

Conclusions: In Korean men, cigarette smoking was as important a risk factor for adenocarcinoma as it was for squamous cell and small-cell lung cancer.

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