【探讨】肺癌发生，二手烟的“功劳”有多大？学术资讯

来源：中华医学会胸心分会

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前言

很多人在体检筛查中发现肺部结节的时候，最常说的一句话就是“我也不抽烟啊！”

既然抽烟与肺癌发生的关系已经被大家熟知，那么从不抽烟的人（never-smoker）出现肺癌是因为什么呢？

一项分析了被动吸烟，也就是二手烟，在从不抽烟的中国人中与肺癌发生的关系的meta分析近期发表在TLCR上。

中国非吸烟者被动吸烟导致肺癌发生的系统回顾和meta分析

Abstract

— 结论—

我们的结论是，在中国从不吸烟的人中，大约16%的肺癌病例可能与被动吸烟有关。这在女性中略高(约18%)，大多数病例是由于家庭接触造成的。

We conclude that approximately 16% of lung cancer cases among never smokers in China are potentially attributable to passive smoking. This is slightly higher among women (around 18%), with most cases occurring due to household exposure.

— 背景—

在制定公共卫生政策时，量化被动吸烟导致的肺癌的发生是必要的一步。在这项研究中，我们估计了中国从不吸烟的人中可归因于被动吸烟的肺癌病例的比例。

Quantifying the occurrence of lung cancer due to passive smoking is a necessary step when forming public health policy. In this study, we estimated the proportion of lung cancer cases attributable to passive smoking among never smokers in China.

— 方法—

我们检索了截至2019年7月的6个数据库，寻找报告中国从不吸烟者与被动吸烟相关的肺癌发生的相对风险(RR)或优势比(OR)的观察性研究。然后使用暴露于被动吸烟的肺癌病例的组合比例和meta分析的合并OR计算人群归因分数(PAF)。数据以其95%的置信区间进行报告。

Six databases were searched up to July 2019 for original observational studies reporting relative risks (RRs) or odds ratios (ORs) for the occurrence of lung cancer associated with passive smoking in Chinese never smokers. The population attributable fraction (PAF) was then calculated using the combined proportion of lung cancer cases exposed to passive smoking and the pooled ORs from meta-analysis. Data are reported with their 95% confidence intervals.

— 结果—

我们选取了31项从不吸烟者的病例对照研究，没有队列研究。其中包括9614例肺癌病例和13093例对照。在9项基于人群的研究和22项基于医院的研究中，被动吸烟导致肺癌的总比例分别为15.5%(9.0-21.4%)和22.7%(16.6-28.3%)。人群研究女性PAF为17.9%(11.4-24.0%)，医院研究为20.9%(14.7-26.7%)。男性的PAF只在基于医院的研究中可计算，为29.0%(95%CI：8.0-45.2%)。在女性中，可归因于家庭暴露的肺癌病例百分比(19.5%)远远高于因工作场所暴露所致的肺癌病例百分比(7.2%)。

We identified 31 case-control studies of never smokers and no cohort studies. These comprised 9,614 lung cancer cases and 13,093 controls. The overall percentages of lung cancers attributable to passive smoking among never smokers were 15.5% (9.0–21.4%) for 9 population-based studies and 22.7% (16.6–28.3%) for 22 hospital-based studies. The PAFs for women were 17.9% (11.4–24.0%) for the population-based studies and 20.9% (14.7–26.7%) for the hospital-based studies. The PAF for men was only calculable for hospital-based studies, which was 29.0% (95% CI: 8.0–45.2%). Among women, the percentage of lung cancer cases attributable to household exposure (19.5%) was much higher than that due to workplace exposure (7.2%).

来源：知识城邦

作者：摇树小蚂蚁

来源：CSTCVS1985 中华医学会胸心分会

原文链接：https://mp.weixin.qq.com/s?__biz=MzA3NDQwNzQ3OA==&mid=2649079924&idx=4&sn=ac9b59e761bbfd54e6a0eb19c434ffd7&chksm=87112b2db066a23b4575f4882f4ec6827aa81613be217e745d764e34e5a54cc0b8b5d32e5c47#rd

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