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J Epidemiol. 2017 Jul;27(7):305-310. doi: 10.1016/j.je.2016.07.005. Epub 2017 Apr 8.

Smoking and subsequent risk of leukemia in Japan: The Japan Public Health Center-based Prospective Study.

Author information

1
Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan; Division of Hematology, Saitama Medical Center, Jichi Medical University, Omiya, Japan.
2
Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: kmatsuo@aichi-cc.jp.
3
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
4
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Abstract

BACKGROUND:

Cigarette smoking has been reported to be associated with an increased risk of leukemia. Most epidemiological evidence on the association between cigarette smoking and leukemia risk is from studies conducted in Western populations, however, and evidence from Asian populations is scarce.

METHODS:

We conducted a large-scale population-based cohort study of 96,992 Japanese subjects (46,493 men and 50,499 women; age 40-69 years at baseline) with an average 18.3 years of follow-up, during which we identified 90 cases of acute myeloid leukemia (AML), 19 of acute lymphoblastic leukemia (ALL), and 28 of chronic myeloid leukemia (CML). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a Cox regression model adjusted for potential confounders.

RESULTS:

When we adjusted for age, sex, and study area, our findings showed no significant association or increasing dose-response relationship between risk of AML and cigarette smoking overall. However, after further adjustment for body mass index and occupation, current smokers with more than 30 pack-years of cigarette smoking had a significantly increased risk of AML compared to never smokers among men (HR 2.21; 95% CI, 1.01-4.83). This increased risk was not clear among women.

CONCLUSIONS:

Our results suggest that cigarette smoking increases the risk of AML in Japanese men. The associations of smoking with AML among women, and with CML and ALL among men and women, should be assessed in future studies.

KEYWORDS:

JPHC study; Leukemia; Prospective cohort study; Smoking

PMID:
28400079
PMCID:
PMC5498405
DOI:
10.1016/j.je.2016.07.005
[Indexed for MEDLINE]
Free PMC Article

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