被动吸烟与非吸烟女性肺癌关系队列研究的Meta分析

Association between passive smoking and lung cancer in non-smoking women:A Meta-analysis of cohort studies

目的基于前瞻性队列研究系统综述非吸烟女性被动吸烟的肺癌风险。方法检索Medline、Embase、Web of Science、知网、万方、SinoMed六种电子数据库截至2021年8月公开发表的文献,纳入被动吸烟与肺癌风险关联的前瞻性队列研究,利用纽卡斯尔—渥太华量表(The Newcastle-Ottawa Scale,NOS)评估文献质量,应用统计软件Stata 14.0和R 3.6.1进行Meta分析。结果本研究纳入女性肺癌队列研究文献共14篇,其中8篇以肺癌发病为研究结局(随访人数/肺癌病例数:424374/832);6篇以肺癌死亡为研究结局(随访人数/肺癌病例数:372204/866)。Meta分析结果显示,非吸烟女性被动吸烟可增加肺癌的发病风险(合并RR=1.23,95%CI:1.04~1.45)和死亡风险(合并RR=1.16,95%CI:1.04~1.28)。亚组分析结果显示,成年期家庭被动吸烟对非吸烟女性肺癌发病风险和死亡风险的合并RR值分别为1.34(95%CI:1.06~1.69)和1.19(95%CI:1.01~1.40);来源于家庭及工作场所的被动吸烟对非吸烟女性肺癌总风险(发病+死亡)的合并RR值分别为1.23(95%CI:1.08~1.41)和1.34(95%CI:1.02~1.76)。结论被动吸烟不仅增加非吸烟女性肺癌发病的风险,也增加非吸烟女性肺癌死亡的风险。

Objective To systematically evaluate the risk of lung cancer in non-smoking women with passive smoking based on prospective cohort studies.Methods Medline,Embase,Web of Science,CNKI,Wanfang Data,and SinoMed databases were searched for prospective cohort studies on the association between passive smoking and lung cancer published up to August,2021.Newcastle-Ottawa Scale was used for quality assessment,and Stata 14.0 and R 3.6.1 were used for meta-analysis.Results A total of 14 cohort studies on lung cancer in women were included in this study,among which 8 were set the onset of lung cancer as study outcome(number of individuals followed up/number of lung cancer cases:424374/832)and 6 were set death due to lung cancer as study outcome(number of individuals followed up/number of lung cancer cases:372204/866).The meta-analysis showed that passive smoking in non-smoking women was associated with an increased risk of the onset of lung cancer(pooled relative risk RR=1.23,95%CI:1.04-1.45)and death due to lung cancer(pooled RR=1.16,95%CI:1.04-1.28).The pooled relative risk of the onset of lung cancer due to adulthood family exposure was 1.34(95%CI:1.06-1.69),and the pooled relative risk of death due to lung cancer for adulthood family exposure was 1.19(95%CI:1.01-1.40).The pooled relative risk of lung cancer caused by passive smoking due to family exposure was 1.23(95%CI:1.08-1.41),and the pooled relative risk of lung cancer due to workplace exposure was 1.34(95%CI:1.02-1.76).Conclusion Passive smoking may increase the risk of the onset of lung cancer and the risk of death due to lung cancer in non-smoking women.