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Int J Public Health. 2017 Jan;62(1):73-83. doi: 10.1007/s00038-016-0856-2. Epub 2016 Jul 15.

Cancer risk in waterpipe smokers: a meta-analysis.

Author information

1
Department of Global and Public Health, Weill Cornell Medicine-Qatar, Doha, Qatar. ram2026@qatar-med.cornell.edu.
2
Department of Global and Public Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
3
Dean's Office, Weill Cornell Medicine-Qatar, Doha, Qatar.
4
Smoking Cessation Program, Hamad Medical Corporation, Doha, Qatar.
5
Department of Surgery, New York Medical College, Valhalla, New York, USA.
6
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.

Abstract

OBJECTIVES:

To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder.

METHODS:

We performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias.

RESULTS:

We retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26-3.90), esophageal cancer (1.84; 1.42-2.38) and lung cancer (2.22; 1.24-3.97), with no evidence of heterogeneity or publication bias. Increased risk was also observed for stomach and bladder cancer but based mainly on poor-quality studies. For colorectum, liver and for all sites combined risk estimates were elevated, but there were insufficient reports to perform a meta-analysis.

CONCLUSIONS:

Contrary to the perception of the relative safety of waterpipe smoking, this meta-analysis provides quantitative estimates of its association with cancers of the head and neck, esophagus and lung. The scarcity and limited quality of available reports point out the need for larger carefully designed studies in well-defined populations.

KEYWORDS:

Cancer; Hubble bubble; Meta-analysis; Shisha; Smoking; Waterpipe

PMID:
27421466
PMCID:
PMC5288449
DOI:
10.1007/s00038-016-0856-2
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Compliance with ethical standards Funding This work has been supported by Weill Cornell Medicine-Qatar Department of Global and Public Health and Biomedical Research Program funded by the Qatar Foundation. Ethical approval This article does not contain any studies with human participants or animals performed by any of the authors. Conflict of interest Ravinder Mamtani declares that he has no conflict of interest. Sohaila Cheema declares that she has no conflict of interest. Javaid Sheikh declares that he has no conflict of interest. Ahmad Al Mulla declares that he has no conflict of interest. Albert Lowenfels declares that he has no conflict of interest. Patrick Maisonneuve declares that he has no conflict of interest.

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